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PMID- 29742721
DCOM- 20180516
LR  - 20180516
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 19
DP  - 2018 May
TI  - Coexistence of Lambert-Eaton myasthenic syndrome and autoimmune encephalitis with
      anti-CRMP5/CV2 and anti-GABAB receptor antibodies in small cell lung cancer: A
      case report.
PG  - e0696
LID - 10.1097/MD.0000000000010696 [doi]
AB  - RATIONALE: Autoimmune encephalitis and Lambert-Eaton myasthenic syndrome are
      classic paraneoplastic neurological conditions common in patients with small cell
      lung cancer. PATIENT CONCERNS: The patient complained of tiredness, fluctuating
      recent memory loss, and inability to find his home. His family members reported a
      change in character, irritability, and paranoia. One month later, the patient had
      1 grand mal seizure lasting 5 minutes. DIAGNOSIS: The patient was diagnosed with 
      limbic encephalitis combined with Lambert-Eaton myasthenic syndrome. The
      gamma-aminobutyric acid B (GABAB) receptor and collapsin response mediator
      protein 5 (CRMP5, also called CV2) antibody test results were positive. Nine
      months after the onset of symptoms, the patient was diagnosed with small cell
      lung cancer. INTERVENTIONS: The patient was administered intravenous
      immunoglobulin for 5 days. He was then treated with 60 mg prednisone once per
      day. The prednisone dose was gradually reduced by 1 tablet every 2 weeks. After
      the diagnosis, the patient underwent 6 courses of chemotherapy with cisplatin
      combined with sequential chemoradiation therapy. OUTCOMES: The patient was able
      to take care of himself. Neurological examination revealed a lower limb proximal 
      muscle strength level of 4 and a reduced limb tendon reflex. The patient had
      deficits in short-term memory, a Mini-Mental State Examination score of 26,
      Montreal Cognitive Assessment score of 24, Self-rating Depression Scale score of 
      54 (mild depression), and Self-Rating Anxiety Scale score of 42 (normal).
      LESSONS: Autoimmune diseases of the peripheral and central nervous systems can be
      observed at the same time in patients with small cell lung cancer, even when
      magnetic resonance imaging findings are negative and immune therapy is effective.
FAU - Li, Hongfang
AU  - Li H
AD  - Department of Neurology, Affiliated Hospital of Jining Medical University,
FAU - Zhang, Aimei
AU  - Zhang A
AD  - Department of Neurology, Affiliated Hospital of Jining Medical University,
FAU - Hao, Yanlei
AU  - Hao Y
AD  - Department of Neurology, Affiliated Hospital of Jining Medical University,
FAU - Guan, Hongzhi
AU  - Guan H
AD  - Department of Neurology, Peking Union Medical College Hospital, Chinese Academy
      of Medical Sciences, Beijing, People's Republic of China.
FAU - Lv, Zhanyun
AU  - Lv Z
AD  - Department of Neurology, Affiliated Hospital of Jining Medical University,
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Antibodies)
RN  - 0 (DPYSL5 protein, human)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
RN  - 0 (Nerve Tissue Proteins)
RN  - 0 (Receptors, GABA-B)
RN  - VB0R961HZT (Prednisone)
RN  - Hashimoto's encephalitis
SB  - IM
MH  - Anti-Inflammatory Agents/therapeutic use
MH  - Antibodies/*blood
MH  - Encephalitis/*complications/drug therapy/immunology
MH  - Hashimoto Disease/*complications/drug therapy/immunology
MH  - Humans
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Immunologic Factors/therapeutic use
MH  - Lambert-Eaton Myasthenic Syndrome/*complications/drug therapy/immunology
MH  - Lung Neoplasms/*complications/therapy
MH  - Male
MH  - Middle Aged
MH  - Nerve Tissue Proteins/*immunology
MH  - Prednisone/therapeutic use
MH  - Receptors, GABA-B/*immunology
MH  - Small Cell Lung Carcinoma/*complications/therapy
EDAT- 2018/05/10 06:00
MHDA- 2018/05/17 06:00
CRDT- 2018/05/10 06:00
PHST- 2018/05/10 06:00 [entrez]
PHST- 2018/05/10 06:00 [pubmed]
PHST- 2018/05/17 06:00 [medline]
AID - 10.1097/MD.0000000000010696 [doi]
AID - 00005792-201805110-00040 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(19):e0696. doi: 10.1097/MD.0000000000010696.