Department of Neurology, Clínica Universidad de Navarra, Avda. Pio XII 36, 31008 Pamplona, Spain.
Neuromuscul Disord. 2011 Feb;21(2):126-8. doi: 10.1016/j.nmd.2010.10.003. Epub 2010 Nov 5.
Dysphagia is a common symptom in neuromuscular junction disorders, but it rarely occurs in isolation or is the presenting feature. We describe a patient presenting with isolated dysphagia to liquids. Electrophysiological studies, such as repetitive nerve stimulation and single-fiber electromyography, were normal. Serum anti-P/Q-type voltage-gated calcium-channel (anti-P/Q-type VGCC) and anti-acetylcholine receptor (AChR ab) antibodies were above the normal range. A computed tomography scan showed a mediastinal mass corresponding to a thymic carcinoma. After chemotherapy, surgical removal of the thymic carcinoma and radiotherapy, the patient no longer complained of dysphagia, AChR ab titers were reduced and anti-P/Q-type VGCC antibodies became negative. To the best of our knowledge, no previous reports of a paraneoplastic myasthenic syndrome related to thymic carcinoma with both anti-P/Q-type VGCC and AChR antibodies have been described.
吞咽困难是神经肌肉接头疾病的常见症状，但很少单独出现或作为主要表现。我们描述了一例以单纯液体吞咽困难为表现的患者。电生理学研究，如重复神经刺激和单纤维肌电图，正常。血清抗 P/Q 型电压门控钙通道（抗 P/Q 型 VGCC）和抗乙酰胆碱受体（AChR ab）抗体高于正常范围。计算机断层扫描显示纵隔肿块与胸腺癌相对应。化疗、胸腺癌切除和放疗后，患者不再主诉吞咽困难，AChR ab 滴度降低，抗 P/Q 型 VGCC 抗体转为阴性。据我们所知，以前没有报道过与胸腺癌相关的副瘤性肌无力综合征同时伴有抗 P/Q 型 VGCC 和 AChR 抗体。
