Prospective study into the incidence of Lambert Eaton myasthenic syndrome in small cell lung cancer.

Abstract

INTRODUCTION:

The Lambert Eaton myasthenic syndrome (LEMS) is a paraneoplastic disorder associated with raised serum voltage-gated calcium channel (VGCC) antibodies in patients with small cell lung cancer (SCLC). VGCC can also be found in patients with SCLC and cerebellar ataxia. This was a prospective study to assess the incidence of clinical and subclinical LEMS or other neurologic disease in patients with SCLC.

PATIENTS AND METHODS:

Sixty-three unselected patients with cytologically or histologically confirmed SCLC consented to participate. Pretreatment assessment included a neurologic symptom questionnaire, examination for physical signs of LEMS or ataxia, measurement of serum titers of antibodies to P/Q-type VGCCs by radioimmunoassay in all patients and electrophysiological examination where appropriate.

RESULTS:

Neurologic symptoms unrelated to LEMS occurred in 26% of patients. Five patients (8%) had raised serum VGCC antibodies (range, 69-1553 pM/l) diagnostic of LEMS, two (3%) of whom had LEMS on clinical and electrophysiological grounds. Both also had mild cerebellar ataxia. There was no association between serum VGCC antibody titer and survival.

CONCLUSION:

Routine measurement of VGCC antibodies in patients without clinical LEMS is unlikely to assist either in management of SCLC or in assessment of prognosis.

• Authors: Miranda Payne, Penny Bradbury, Bethan Lang, Angela Vincent, Cheng Han, John Newsom-Davis, Denis Talbot
• Journal: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer (J Thorac Oncol) Vol. 5 Issue 1 Pg. 34-8 (Jan 2010) ISSN: 1556-1380 [Electronic] United States
• PMID: 19934775 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Autoantibodies
• Calcium Channels

Topics

• Adult
• Aged
• Aged, 80 and over
• Autoantibodies (blood)
• Calcium Channels (immunology)
• Cohort Studies
• Female
• Humans
• Incidence
• Ion Channel Gating
• Lambert-Eaton Myasthenic Syndrome (drug therapy, epidemiology, immunology)
• Lung Neoplasms (epidemiology, immunology, pathology)
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• Prospective Studies
• Radioimmunoassay
• Small Cell Lung Carcinoma (epidemiology, immunology, pathology)
• Survival Rate