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Myasthenia Gravis Related to Small Cell Lung Carcinoma
Laura López-Viñas1, Esmeralda Rocío-Martín2, Salvador Delis-Gómez3
1Clinical Neurophysiology Department, Fundación Jiménez Díaz University Hospital, Madrid, ESP.
Abstract:
Myasthenia gravis is a neuromuscular disease that causes weakness in skeletal muscles because of the presence of acetylcholine receptor antibodies. These antibodies produce a compromise in the end-plate potential, reducing the safety factor for effective synaptic transmission. Clinically, this manifests as muscle weakness and, in severe cases, respiratory failure. There is widespread knowledge about the association between small cell lung carcinoma and Lambert- Eaton myasthenic syndrome, but not with other neuromuscular disorders, such as myasthenia gravis. We present a patient with small cell lung carcinoma who presented weakness affecting the proximal muscles over the last three years, and electromyography findings suggesting myasthenia gravis. After this electrodiagnosis, analytical tests showed an increase in anti-acetylcholine receptor antibodies. Given these findings, we can affirm that neurophysiological tests provide a significant value in diagnosing myasthenia gravis, as anti-acetylcholine receptor antibodies were negative at the moment of the electromyography's performance. Likewise, it is essential to consider a paraneoplastic syndrome in this type of carcinoma.
Insights
Small cell lung carcinoma can present with myasthenia gravis, a neuromuscular disorder. Neurophysiological tests are crucial for diagnosing myasthenia gravis, especially when antibodies are initially negative.
Area of Science:
- Neurology
- Oncology
- Immunology
Background:
- Myasthenia gravis is a neuromuscular disorder caused by acetylcholine receptor antibodies, leading to muscle weakness.
- Small cell lung carcinoma is known to associate with Lambert-Eaton myasthenic syndrome, but less commonly with myasthenia gravis.
Observation:
- A patient with SCLC presented with three years of proximal muscle weakness.
- Electromyography suggested myasthenia gravis, despite initial negative anti-acetylcholine receptor antibody tests.
Findings:
- Subsequent analytical tests confirmed elevated anti-acetylcholine receptor antibodies.
- Neurophysiological tests proved valuable in diagnosing myasthenia gravis in this SCLC patient.
Implications:
- This case highlights the importance of considering myasthenia gravis as a paraneoplastic syndrome in SCLC patients.
- Early electrodiagnostic evaluation is critical for timely myasthenia gravis diagnosis and management.
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