Arellano-Aguilar Gregorio, Núñez-Mojica Erik Santiago, Gutiérrez-Velazco José Luis, Domínguez-Carrillo Luis Gerardo
Medicine Division. Hospital Ángeles León. León, Gto., Mexico.
Undergraduate Intern. Hospital Ángeles León. León, Gto., Mexico.
Cir Cir. 2019;86(1):72-76. doi: 10.24875/CIRUE.M18000011.
Neurological paraneoplastic syndromes are rare, occur in 0.01% of all cancer patients; like part of them, the Lambert-Eaton syndrome is an autoimmune presynaptic disorder of neuromuscular transmission characterized by muscle weakness and neurovegetative dysfunction, and often associated with small cell lung cancer.
A 72 years old female with a family history of lung cancer and leukemia, with 7 months of dry cough and 3 months with waist and pelvic muscle weakness, oropharyngeal dysphagia, dry mouth, chronic constipation and weight loss of 10 kg.
patient prostrated; clinical muscle examination: pelvic muscles waist -3/5 and -4/5 the rest; diminished reflexes. Laboratory normal parathormone and hypercalcemia. With electrophysiological study and positive anti-voltage-gated calcium channel antibodies, confirming Lambert-Eaton syndrome and imaging studies with neoplastic condition in brain, liver and kidney, with unspecified primary origin.
神经系统副肿瘤综合征较为罕见，在所有癌症患者中发生率为0.01%；其中部分类型，如兰伯特-伊顿综合征，是一种神经肌肉传递的自身免疫性突触前疾病，其特征为肌肉无力和神经植物功能障碍，常与小细胞肺癌相关。
一名72岁女性，有肺癌和白血病家族史，干咳7个月，伴有3个月的腰部和骨盆肌肉无力、口咽吞咽困难、口干、慢性便秘以及体重减轻10千克。
患者极度虚弱；临床肌肉检查：骨盆肌肉和腰部肌肉力量为3/5和4/5（其余部位肌力未提及）；反射减弱。实验室检查甲状旁腺素正常但血钙过高。通过电生理研究及抗电压门控钙通道抗体检测呈阳性，确诊为兰伯特-伊顿综合征，影像学检查显示脑、肝和肾存在肿瘤性病变，原发灶未明确。
