Small-cell lung cancer presenting with Lambert-Eaton myasthenic syndrome and respiratory failure
Journal
Journal of the Formosan Medical Association
Journal Volume
101
Journal Issue
12
Pages
871-874
Date Issued
2002
Author(s)
Abstract
Lambert-Eaton myasthenic syndrome (LEMS) is a neuromuscular disorder characterized by defective neurotransmitter release at presynaptic terminals. It is caused by an IgG autoantibody reacting against voltage-gated calcium channels. Severe LEMS complicated by ventilatory failure is rare. We report a case of small-cell lung cancer (SCLC) presenting with LEMS and ventilatory failure in a 67-year-old man who initially presented with progressive limb weakness for 6 months and tachypnea with shallow breathing for 1 week. LEMS was diagnosed through electrophysiologic studies. Chest radiography and computerized tomography showed a huge mass lesion over the left anterior and middle mediastinum with an encasement of the left pulmonary artery. Cytologic examination of ultrasound-guided fine needle aspiration disclosed SCLC. Successful treatment in combination with plasma exchange and chemotherapy resulted in dramatic tumor regression and LEMS remission, which were confirmed by chest radiography and electrophysiologic studies. This case suggests that plasma exchange and chemotherapy can be effective in treating SCLC with severe LEMS that produces ventilatory failure.
SDGs
Other Subjects
amoxicillin; autoantibody; calcium; calcium channel; cisplatin; clavulanate potassium; etoposide; hormone derivative; immunoglobulin G; neurotransmitter; oral antidiabetic agent; aged; article; aspiration biopsy; brain disease; breathing disorder; case report; channel gating; clinical examination; clinical feature; computer assisted tomography; cytology; death; diabetes mellitus; Eaton Lambert syndrome; echography; electrophysiology; human; lung small cell cancer; male; mediastinum tumor; muscle weakness; nerve conduction; nerve ending; neuromuscular disease; neurotransmitter release; plasmapheresis; prostate cancer; pulmonary artery; remission; respiratory failure; respiratory tract infection; respiratory tract intubation; tachypnea; thorax radiography; treatment outcome; Aged; Carcinoma, Small Cell; Humans; Lambert-Eaton Myasthenic Syndrome; Lung Neoplasms; Male; Respiratory Insufficiency
Type
journal article