Ohkubo K, Ohishi K, Motomura M, Sakai K, Tsujihata M, Nagataki S
First Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
No To Shinkei. 1994 Mar;46(3):285-9.
We report a patient with small cell lung cancer associated with Lambert-Eaton myasthenic syndrome (LEMS) and subacute cerebellar degeneration (SCD). The patient was a 71-year-old man suffering from weakness of the limbs and a gait disturbance who developed limb ataxia and dysarthria one month after admission. Electrophysiologic studies confirmed the diagnosis of Lambert-Eaton myasthenic syndrome. Chest X-rays 2 months after admission revealed an abnormal shadow, and small cell lung cancer was diagnosed on the basis of biopsy specimens. Anti-voltage-gated calcium channel antibody was positive. Anti-Yo and -Hu antibodies were negative. The patient was treated by plasmapheresis and chemotherapy, which resulted in a transient improvement in the LEMS symptoms but not in the SCD. Fifteen cases of LEMS associated with SCD have been reported in the Japanese literature, and all were accompanied by small cell lung cancer. We discuss the frequency of association with LEMS and SCD and the effects of plasmapheresis and chemotherapy in both diseases.
我们报告了一例患有小细胞肺癌并伴有兰伯特-伊顿肌无力综合征(LEMS)和亚急性小脑变性(SCD)的患者。该患者为一名71岁男性,患有肢体无力和步态障碍,入院一个月后出现肢体共济失调和构音障碍。电生理研究证实了兰伯特-伊顿肌无力综合征的诊断。入院两个月后的胸部X光片显示有异常阴影,根据活检标本诊断为小细胞肺癌。抗电压门控钙通道抗体呈阳性。抗Yo和抗Hu抗体呈阴性。该患者接受了血浆置换和化疗,这使得LEMS症状有短暂改善,但SCD症状未改善。日本文献中已报道了15例与SCD相关的LEMS病例,所有病例均伴有小细胞肺癌。我们讨论了LEMS和SCD的关联频率以及血浆置换和化疗对这两种疾病的影响。