• Internal medicine · Apr 2023

    Case Reports

    Lambert-Eaton Myasthenic Syndrome Recurrence Induced by Pembrolizumab in a Patient with Non-small-cell Lung Cancer.

    • Yuki Takigawa, Hiromi Watanabe, Yoshio Omote, Sunao Kurihara, Tomoyoshi Inoue, Miho Fujiwara, Sho Mitsumune, Kiriko Onishi, Kenichiro Kudo, Akiko Sato, Ken Sato, Keiichi Fujiwara, and Takuo Shibayama.
    • Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan.
    • Intern. Med. 2023 Apr 1; 62 (7): 105510581055-1058.

    AbstractA 73-year-old woman in complete remission from localized small-cell lung cancer associated with Lambert-Eaton myasthenic syndrome (LEMS) 22 years earlier was referred to our hospital and diagnosed with non-small-cell lung cancer. After three courses of pembrolizumab, an immune checkpoint inhibitor, the patient complained of muscle weakness, fatigue, ptosis, and dysarthria. The anti-voltage-gated calcium channel antibody level was elevated, and waxing was observed on a high-frequency repetitive stimulation test using an electromyogram. We diagnosed her with recurrence of LEMS as an immune-related adverse event (irAE) induced by pembrolizumab. After intravenous immunoglobulin therapy, the patient's symptoms improved, and she was discharged.

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