We studied whether a difference exists in the development of symptoms of the Lambert-Eaton myasthenic syndrome (LEMS) between patients with or without small cell lung cancer (SCLC). We assessed symptoms in 38 LEMS pat...We studied whether a difference exists in the development of symptoms of the Lambert-Eaton myasthenic syndrome (LEMS) between patients with or without small cell lung cancer (SCLC). We assessed symptoms in 38 LEMS patients, 13 with SCLC, by interviewing them using a structured checklist, backed up by a review of their clinical records, and compared the frequency and time scale of symptoms during the course of LEMS. Bulbar (87%) and autonomic (95%) symptoms for the whole group were more common than reported in the literature. Frequencies of symptoms did not differ significantly between patients with and without SCLC, but symptoms in patients with SCLC appeared within a shorter time-frame, indicating a more rapid clinical course. The presence of a particular symptom associated with LEMS did not predict the presence of SCLC, but in patients with rapidly progressive LEMS the possibility of underlying lung cancer should be of particular concern.展开更多
In view of the clustering of autoimmune diseases (AIDs), we studied the frequency and nature of additional AIDs in patients with the Lambert- Eaton myasthenic syndrome (LEMS) and their family members, in both small ce...In view of the clustering of autoimmune diseases (AIDs), we studied the frequency and nature of additional AIDs in patients with the Lambert- Eaton myasthenic syndrome (LEMS) and their family members, in both small cell lung carcinoma (SCLC) related and non- tumour (NT) related cases. Additional AIDs in patients with LEMS were assessed by interviewing the patient and studying the medical record. Family histories up to second- degree family members were established by interviewing patients, controls and family members. Forty- four patients with LEMS were assessed, of whom eighteen (41 % ) had SCLC. In the NT group seven patients (27 % ) had an additional AID, in the SCLC group two (11 % ) (p = 0.20). Thyroid disorder (five patients) and insulin dependent diabetes mellitus (two patients)- were the most common AIDs. AIDs were significantly more frequent in families of patients with NT- LEMS (64% ) than in control families (27 % ) (p = 0.002), which was not found in SCLC- LEMS (36 % , p = 0.53). Affected family members were linked to the NT- LEMS patient through the maternal line in all cases. In conclusion, AIDs were more frequently found in LEMS patients without a tumour and their families, which could not be shown for SCLC- LEMS. This suggests that NT- LEMS shares immunogenetic factors with other AIDs. In families of NT- LEMS, a remarkable preponderance of maternal inheritance was seen, as has been reported previously in myasthenia gravis.展开更多
文摘We studied whether a difference exists in the development of symptoms of the Lambert-Eaton myasthenic syndrome (LEMS) between patients with or without small cell lung cancer (SCLC). We assessed symptoms in 38 LEMS patients, 13 with SCLC, by interviewing them using a structured checklist, backed up by a review of their clinical records, and compared the frequency and time scale of symptoms during the course of LEMS. Bulbar (87%) and autonomic (95%) symptoms for the whole group were more common than reported in the literature. Frequencies of symptoms did not differ significantly between patients with and without SCLC, but symptoms in patients with SCLC appeared within a shorter time-frame, indicating a more rapid clinical course. The presence of a particular symptom associated with LEMS did not predict the presence of SCLC, but in patients with rapidly progressive LEMS the possibility of underlying lung cancer should be of particular concern.
文摘In view of the clustering of autoimmune diseases (AIDs), we studied the frequency and nature of additional AIDs in patients with the Lambert- Eaton myasthenic syndrome (LEMS) and their family members, in both small cell lung carcinoma (SCLC) related and non- tumour (NT) related cases. Additional AIDs in patients with LEMS were assessed by interviewing the patient and studying the medical record. Family histories up to second- degree family members were established by interviewing patients, controls and family members. Forty- four patients with LEMS were assessed, of whom eighteen (41 % ) had SCLC. In the NT group seven patients (27 % ) had an additional AID, in the SCLC group two (11 % ) (p = 0.20). Thyroid disorder (five patients) and insulin dependent diabetes mellitus (two patients)- were the most common AIDs. AIDs were significantly more frequent in families of patients with NT- LEMS (64% ) than in control families (27 % ) (p = 0.002), which was not found in SCLC- LEMS (36 % , p = 0.53). Affected family members were linked to the NT- LEMS patient through the maternal line in all cases. In conclusion, AIDs were more frequently found in LEMS patients without a tumour and their families, which could not be shown for SCLC- LEMS. This suggests that NT- LEMS shares immunogenetic factors with other AIDs. In families of NT- LEMS, a remarkable preponderance of maternal inheritance was seen, as has been reported previously in myasthenia gravis.
