How to Cite
Abstract
Lambert Eaton myasthenic syndrome is a paraneoplastic autoimmune pathology mostly associated with lung cancer, which manifests itself with involvement of the neuromuscular junction and autonomic dysfunctions. We present the case of a 58-year-old female patient who was diagnosed with small cell lung cancer and who subsequently presented the classic Lambert Eaton myasthenic syndrome (proximal lower limb weakness, autonomic dysfunction, and hyporeflexia). It was approached through neurophysiological tests (electromyography), confirming its diagnosis in association with the clinical picture. The case presented below highlights the association of pulmonary neoplasms with the diagnosis of Lambert Eaton myasthenic syndrome and the improvement of symptoms thanks to symptomatic and oncological treatment.
Keywords
References
Todisco V, Cirillo G, Capuano R, d'Ambrosio A, Tedeschi G, Gallo A. Stimulated single-fiber electromyography (sSFEMG) in Lambert-Eaton syndrome. Clinical Neurophysiology Practice. 2018; 3:148-150. https://doi.org/10.1016/j.cnp.2018.07.001
Ruelle L, Bentea G, Sideris S, El Koulali M, Holbrechts S, Lafitte J et al. Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature Part 4: Neurological paraneoplastic syndromes, involving the peripheral nervous system and the neuromuscular junction and muscles. Lung Cancer. 2017; 111:150-163. https://doi.org/10.1016/j.lungcan.2017.07.025
Sweeney L, Howe T. Paraneoplastic syndromes. Medicine. 2020; 48(2):144-147. https://doi.org/10.1016/j.mpmed.2019.11.015
Tas D. Paraneoplastic Syndromes in Lung Cancer. Lung Cancer - Strategies for Diagnosis and Treatment. 2018.
https://doi.org/10.5772/intechopen.79127
Bukhari S, Soomro R, Fawwad S, Alvarez C, Wallach S. Adenocarcinoma of Lung Presenting as Lambert-Eaton Myasthenic Syndrome. Journal of Investigative Medicine High Impact Case Reports. 2017; 5(3). https://doi.org/10.1177/2324709617721251
Matsumoto H, Ugawa Y. Lambert-Eaton Myasthenic Syndrome: A Review. Journal of General and Family Medicine. 2016; 17(2): 138-143. DOI: https://doi.org/10.14442/jgfm.17.2_138
Abenroth D, Smith A, Greenlee J, Austin S, Clardy S. Lambert-Eaton myasthenic syndrome: Epidemiology and therapeutic response in the national veterans affairs population. Muscle & Nerve. 2017; 56(3): 421-426. https://doi.org/10.1002/mus.25520
Schoser B, Eymard B, Datt J, Mantegazza R. Lambert-Eaton myasthenic syndrome (LEMS): a rare autoimmune presynaptic disorder often associated with cancer. Journal of Neurology. 2017; 264: 1854-1863. https://doi.org/10.1007/s00415-017-8541-9
Agrawal K, Agrawal N. Lambert-Eaton Myasthenic Syndrome Secondary to Nivolumab and Ipilimumab in a Patient with Small-Cell Lung Cancer. Case Reports in Neurological Medicine. 2019. https://doi.org/10.1155/2019/5353202
Harper C, Lennon V. Lambert-Eaton Syndrome. Current Clinical Neurology. 2018; 221-237. https://doi.org/10.1007/978-3-319-73585-6_14
Zhang K, Liu W, Li Y, Zhang K, Gao X, Wang J. Mediastinal small cell cancer associated with Lambert-Eaton myasthenic syndrome: A case report. Experimental and Therapeutic Medicine. 2015; 10(1): 117-120. https://doi.org/10.3892/etm.2015.2454
Wang A, Zhang X, Yi J, Zhu M, Zhang Y. Successful treatment of advanced lung adenocarcinoma complicated with Lambert‐Eaton myasthenic syndrome: A case report and literature review. Thoracic Cancer. 2020; 11(5): 1334-1338. https://doi.org/10.1111/1759-7714.13385
Katyal N, Govindarajan R. Pure Ocular Weakness as the Initial Manifestation of Lambert-Eaton Myasthenic Syndrome. Cureus. 2017; 9(12). https://doi.org/10.7759/cureus.2007
Ivanovski T, Miralles F. Lambert-Eaton Myasthenic syndrome: early diagnosis is key. Degenerative Neurological and Neuromuscular Disease. 2019; 9: 27-37. https://doi.org/10.2147/DNND.S192588
Motomura M, Nakata R, Shiraishi H. Lambert-Eaton myasthenic syndrome: Clinical review. Clinical and Experimental Neuroimmunology. 2016; 7(3): 238-245. https://doi.org/10.1111/cen3.12326
Merino-Ramírez M, Bolton C. Review of the Diagnostic Challenges of Lambert-Eaton Syndrome Revealed Through Three Case Reports. Canadian Journal of Neurological Sciences. 2016; 43(5): 635-647. https://doi.org/10.1017/cjn.2016.268
Hajela R, Huntoon K, Atchison W. Lambert-Eaton syndrome antibodies target multiple subunits of voltage-gated Ca2+channels. Muscle & Nerve. 2014; 51(2): 176-184. https://doi.org/10.1002/mus.24295
Anwar A, Jafri F, Ashraf S, Jafri M, Fanucchi M. Paraneoplastic syndromes in lung cancer and their management. Annals of Translational Medicine. 2019; 7(15): 359-359. https://doi.org/10.21037/atm.2019.04.86
Cetin H, Vincent A. Pathogenic Mechanisms and Clinical Correlations in Autoimmune Myasthenic Syndromes. Seminars in Neurology. 2018; 38(3): 344-354. https://doi.org/10.1055/s-0038-1660500
Kwiatkowski S, Kolasińska K, Knap B, Przystupski D, Kotowski K, Bartosik W et al. An overview of paraneoplastic neurological syndromes - pathophysiology and clinical insight. World Scientific News. 2018; 108: 87-98.Disponible en: https://www.researchgate.net/publication/327221613_An_overview_of_paraneoplastic_neurological_syndromes_-_pathophysiology_and_clinical_insight
Li C, Wang X, Sun L, Deng H, Han Y, Zheng W. Anti‐SOX1 antibody‐positive paraneoplastic neurological syndrome presenting with Lambert‐Eaton myasthenic syndrome and small cell lung cancer: A case report. Thoracic Cancer. 2019; 11(2): 465-469. https://doi.org/10.1111/1759-7714.13290
Kesner V, Oh S, Dimachkie M, Barohn R. Lambert-Eaton Myasthenic Syndrome. Neurologic Clinics. 2018; 36(2): 379-394. https://doi.org/10.1016/j.ncl.2018.01.008
Liu Y, Xi J, Zhou L, Wu H, Yue D, Zhu W et al. Clinical characteristics and long term follow-up of Lambert-Eaton myasthenia syndrome in patients with and without small cell lung cancer. Journal of Clinical Neuroscience. 2019; 65: 41-45. https://doi.org/10.1016/j.jocn.2019.04.003
Anwar A, Saleem S, Ahmed M, Ashraf S, Ashraf S. Recent Advances and Therapeutic Options in Lambert-Eaton Myasthenic Syndrome. Cureus. 2019; 11(8). https://doi.org/10.7759/cureus.5450