[SMLE] Early Induction of IVIg Improved the Performance Status and Enabled Chemotherapy Initiation in PCD-LEMS: A Case R

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Intern Med. 2026 Aug 19. doi: 10.2169/internalmedicine.7251-26. Online ahead of print.

ABSTRACT

A 73-year-old man developed progressive gait disturbance and diplopia over two weeks concomitant with rapidly enlarging pulmonary lesions. Examination revealed proximal lower limb weakness, diminished deep tendon reflexes, ataxic dysarthria, limb and truncal ataxia, and orthostatic hypotension. Nerve conduction studies revealed reduced compound muscle action potentials with postexercise facilitation. Elevated anti-P/Q-type voltage-gated calcium channel antibodies confirmed paraneoplastic cerebellar degeneration (PCD) with Lambert-Eaton myasthenic syndrome (LEMS). Bronchoscopy revealed small-cell lung cancer. Although a poor performance status (PS) initially precluded chemotherapy, high-dose intravenous immunoglobulin therapy improved the PS, enabling cancer treatment. Immunotherapy should be considered when a PCD-LEMS-related poor PS prevents cancer therapy.

PMID:42618261 | DOI:10.2169/internalmedicine.7251-26


Source: https://pubmed.ncbi.nlm.nih.gov/4261826 ... 0&v=2.20.1