一例伴有小细胞肺癌的 Lambert-Eaton 肌无力综合征及乙酰胆碱受体结合抗体滴度的一过性升高。
A case of lambert-eaton myasthenic syndrome with small-cell lung cancer and transient increase in anti-acetylcholine-receptor-binding antibody titer.
机构信息
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. ; Department of Neurology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
出版信息
J Clin Neurol. 2012 Dec;8(4):305-7. doi: 10.3988/jcn.2012.8.4.305. Epub 2012 Dec 21.
BACKGROUND
Lambert-Eaton myasthenic syndrome (LEMS) is a presynaptic neuromuscular junction disorder that is most frequently associated with small-cell lung cancer (SCLC). The titers of antibodies against voltage-gated calcium channels are frequently increased in LEMS, but only rarely is titer of anti-acetylcholine-receptor-binding antibodies (AChR-abs) increased.
CASE REPORT
A 57-year-old male was admitted to our hospital due to dry mouth and eyes and progressive proximal limb weakness of 2 months duration. The results of a repetitive nerve stimulation test disclosed all criteria for the electrophysiological LEMS pattern, and the patient's AChR-abs titer was 0.587 nmol/L. At a follow-up performed 5 years after successful treatment of SCLC and LEMS, his AChR-abs titer had decreased to 0.001 nmol/L.
CONCLUSIONS
We suggest that this was a case of transient pseudopositivity of AChR-abs in SCLC with LEMS.
背景
Lambert-Eaton 肌无力综合征（LEMS）是一种副交感神经肌肉接头疾病，最常与小细胞肺癌（SCLC）相关。电压门控钙通道抗体的滴度在 LEMS 中经常升高，但抗乙酰胆碱受体结合抗体（AChR-abs）的滴度升高则较为罕见。
病例报告
一名 57 岁男性因口干、眼干和进行性近端肢体无力 2 个月而入院。重复神经刺激测试的结果显示出电生理 LEMS 模式的所有标准，且患者的 AChR-abs 滴度为 0.587 nmol/L。在成功治疗 SCLC 和 LEMS 后 5 年的随访中，他的 AChR-abs 滴度已降至 0.001 nmol/L。
结论
我们认为这是 SCLC 伴 LEMS 中 AChR-abs 一过性假阳性的病例。
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