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      SOX‐1 antibodies positive Lambert–Eaton myasthenic syndrome with occult small cell lung cancer: A case report

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          Abstract

          Lambert–Eaton myasthenic syndrome (LEMS) is a rare paraneoplastic neurological syndrome of the neuromuscular transmission. The symptoms often progress slowly and can be misdiagnosed in early stage. Seropositive SOX‐1 antibodies are support for the diagnosis of LEMS and have high specificity for small cell lung cancer (SCLC). In this paper, we report a case of a 56‐year‐old man with smoking history who was admitted to hospital with progressive muscle weakness of the proximal legs. LEMS was diagnosed by repetitive nerve stimulation (RNS) testing and seropositive SOX‐1 antibodies. Primary screening with chest computed tomography (CT) and integrated PET/CT did not reveal any tumor. After continuous follow‐up, SCLC was found by chest CT and confirmed with pathological examination 10 months after the diagnosis of LEMS. Long‐term follow‐up and screening for occult SCLC in LEMS patients with positive SOX‐1 antibodies are very important.

          Abstract

          We report a patient with LEMS who was tested positive for SOX‐1 antibodies and was definitively diagnosed with SCLC by pathological biopsy after 10 months follow‐up.

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          Most cited references17

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          Guillain-Barré syndrome

          Nortina Shahrizaila, Helmar C Lehmann, Satoshi Kuwabara (2021)
          Guillain-Barré syndrome is the most common cause of acute flaccid paralysis worldwide. Most patients present with an antecedent illness, most commonly upper respiratory tract infection, before the onset of progressive motor weakness. Several microorganisms have been associated with Guillain-Barré syndrome, most notably Campylobacter jejuni, Zika virus, and in 2020, the severe acute respiratory syndrome coronavirus 2. In C jejuni-related Guillain-Barré syndrome, there is good evidence to support an autoantibody-mediated immune process that is triggered by molecular mimicry between structural components of peripheral nerves and the microorganism. Making a diagnosis of so-called classical Guillain-Barré syndrome is straightforward; however, the existing diagnostic criteria have limitations and can result in some variants of the syndrome being missed. Most patients with Guillain-Barré syndrome do well with immunotherapy, but a substantial proportion are left with disability, and death can occur. Results from the International Guillain-Barré Syndrome Outcome Study suggest that geographical variations exist in Guillain-Barré syndrome, including insufficient access to immunotherapy in low-income countries. There is a need to provide improved access to treatment for all patients with Guillain-Barré syndrome, and to develop effective disease-modifying therapies that can limit the extent of nerve injury. Clinical trials are currently underway to investigate some of the potential therapeutic candidates, including complement inhibitors, which, together with emerging data from large international collaborative studies on the syndrome, will contribute substantially to understanding the many facets of this disease.
          Article 0 comments Cited 166 times – based on 0 reviews     Review now
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            Lambert-Eaton myasthenic syndrome: from clinical characteristics to therapeutic strategies.

            Maarten J. Titulaer, Bethan Lang, Jan Verschuuren (2011)
            Lambert-Eaton myasthenic syndrome (LEMS) is a neuromuscular autoimmune disease that has served as a model for autoimmunity and tumour immunology. In LEMS, the characteristic muscle weakness is thought to be caused by pathogenic autoantibodies directed against voltage-gated calcium channels (VGCC) present on the presynaptic nerve terminal. Half of patients with LEMS have an associated tumour, small-cell lung carcinoma (SCLC), which also expresses functional VGCC. Knowledge of this association led to the discovery of a wide range of paraneoplastic and non-tumour-related neurological disorders of the peripheral and central nervous systems. Detailed clinical studies have improved our diagnostic skills and knowledge of the pathophysiological mechanisms and association of LEMS with SCLC, and have helped with the development of a protocol for early tumour detection. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Epidemiology, diagnostics, and biomarkers of autoimmune neuromuscular junction disorders

              Anna Punga, Paul Maddison, Jeannine M Heckmann … (2022)
              Article 0 comments Cited 44 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Yanqiang Chen: chenyanqiang497@126.com
                Journal
                Journal ID (nlm-ta): Clin Respir J
                Journal ID (iso-abbrev): Clin Respir J
                Journal ID (doi): 10.1111/(ISSN)1752-699X
                Journal ID (publisher-id): CRJ
                Title: The Clinical Respiratory Journal
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 1752-6981
                ISSN (Electronic): 1752-699X
                Publication date (Electronic): 18 March 2024
                Publication date Collection: March 2024
                Volume: 18
                Issue: 3 ( doiID: 10.1111/crj.v18.3 )
                Electronic Location Identifier: e13740
                Affiliations
                [ 1 ] Department of Neurology Hebei Chest Hospital Shijiazhuang Hebei China
                [ 2 ] Department of Pathology Hebei Chest Hospital Shijiazhuang Hebei China
                Author notes
                [*] [* ] Correspondence

                Yanqiang Chen, Department of Neurology, Hebei Chest Hospital, 372 Shengli North Street, Shijiazhuang, Hebei 050000, China.

                Email: chenyanqiang497@ 123456126.com

                Author information
                https://orcid.org/0009-0009-1275-5420
                Article
                Publisher ID: CRJ13740
                DOI: 10.1111/crj.13740
                PMC ID: 10945390
                PubMed ID: 38497229
                SO-VID: 1b872818-826e-4dee-b48d-9a403248c1fc
                Copyright © © 2024 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date revision received : 23 January 2024
                Date received : 31 October 2023
                Date accepted : 17 February 2024
                Page count
                Figures: 3, Tables: 0, Pages: 4, Words: 2093
                Categories
                Subject: Brief Report
                Subject: Brief Report
                Custom metadata
                source-schema-version-number 2.0
                cover-date March 2024
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.9 mode:remove_FC converted:18.03.2024

                ScienceOpen disciplines: Respiratory medicine
                Keywords: lambert–eaton myasthenic syndrome,occult cancer,small cell lung cancer,sox‐1 antibody
                Data availability:
                ScienceOpen disciplines: Respiratory medicine
                Keywords: lambert–eaton myasthenic syndrome, occult cancer, small cell lung cancer, sox‐1 antibody

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