Coexistence of Lambert‐Eaton myasthenic syndrome and subacute cerebellar degeneration
Coexistence of Lambert‐Eaton myasthenic syndrome and subacute cerebellar degeneration
复制标题
兰伯特-伊顿肌无力综合征与亚急性小脑变性的共存
作者：
A. Blumenfeld;Lawrence D. Recht;David A. Chad;Umberto Degirolami;T. Griffin;K. Jaeckle
一位61岁的女性，患有两种副肿瘤性神经系统疾病--Lambert-Eaton肌无力综合征（LEMS）和亚急性小脑变性（SCD），这两种疾病的诊断比小细胞肺癌早了15个月。在确定肿瘤之前开始血浆置换对LEMS有有益的影响，但不影响SCD。原发性肿瘤的化疗也与LEMS的改善相关，但与血浆置换术一样，对SCD没有影响。虽然LEMS和SCD的发病机制被认为主要由体液免疫因子介导，但差异性治疗反应表明，这两种疾病的组织损伤或对组织损伤的易感性或两者的机制不同。
A 61-year-old woman presented with two paraneoplastic neurologic disorders—Lambert-Eaton myasthenic syndrome (LEMS) and sub-acute cerebellar degeneration (SCD)—that antedated the diagnosis of small-cell carcinoma of the lung by 15 months. Plasmapheresis initiated before the identification of the tumor had a beneficial effect on LEMS but did not affect the SCD. Chemotherapy administered for treatment of the primary tumor was also associated with improvement of LEMS but, like plasmapheresis, had no effect on SCD. While the pathogenesis of both LEMS and SCD is thought to be mediated predominantly by humoral immune factors, a differential therapeutic response indicates that mechanisms of tissue damage or susceptibility to tissue injury, or both, differ in these two disorders.