Vogt Alexander, Wang Shuang, Ventour Dale
Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
BMJ Case Rep. 2013 Sep 12;2013:bcr2013008883. doi: 10.1136/bcr-2013-008883.
A 70-year-old retired general practitioner with known follicular lymphoma presented with ptosis, dysphagia and progressive weakness in his upper and lower limbs. Despite having positive antibodies for myasthenia gravis he did not respond to conventional treatment with pyridostigmine, immunoglobulins and steroids. After 1 week on a general ward, he required intensive care for non-invasive ventilation. On the intensive care unit, he developed a secondary paraneoplastic syndrome in the form of a syndrome of inappropriate antidiuretic hormone secretion and required a tracheostomy for ventilatory support. After 1 week of invasive ventilation and remaining fully conscious throughout, he declined further treatment and passed away.
一名70岁的退休全科医生，已知患有滤泡性淋巴瘤，出现上睑下垂、吞咽困难以及上下肢进行性无力。尽管其重症肌无力抗体呈阳性，但他对吡啶斯的明、免疫球蛋白和类固醇的常规治疗没有反应。在普通病房住院1周后，他需要重症监护以进行无创通气。在重症监护病房，他出现了一种继发性副肿瘤综合征，表现为抗利尿激素分泌异常综合征，并且需要气管切开以获得通气支持。在进行有创通气1周且始终保持完全清醒后，他拒绝进一步治疗并去世。
