• Jin Wang, Xiaokun Mi, Feng Ban, and Jingxia Zhao.
• Department of Neurology, The Fourth Hospital of Hebei Medical University, Jian Kang Road No.12, Shijiazhuang, China.
• Medicine (Baltimore). 2023 Sep 29; 102 (39): e35325e35325.

RationaleAnti-amphiphysin antibodies are uncommonly detected in paraneoplastic neurologic syndromes (PNS), especially in patients with small cell lung cancer. Here, we report the first case of anti-amphiphysin antibody-associated PNS with pruritus and dysphagia as the first complaints.Patient ConcernsThe patient was a 58-year-old man who sought medical advice with a chief complaint of dysphagia and the lung occupancy. We found that he had developed progressive pruritus several months ago.DiagnosesIn the outer basal segment of the right lung lower lobe, PET-CT revealed small occupancies with hypermetabolism. Later, the pathology showed small cell lung cancer. And anti-amphiphysin antibodies were detected in serum. Above all, the patient's symptoms improved significantly after antitumor treatment. Even neither of the 2 cranial enhancement MRIs showed any meaningful imaging signs, the above evidence could confirm the diagnosis of PNS.InterventionsThe chemotherapy regimen was etoposide 0.1g d1-3+cisplatin 40 mg d1-3 (q3w). Paroxetine 20 mg/day was given to relieve the itching.OutcomesAfter the treatment, the Watian water swallowing test dropped from grade 5 to grade 1, the intense itching also became tolerable.LessonsClinicians should consider diagnoses other than anxiety states or esophageal cancer in a patient with pruritus and dysphagia, such as PNS.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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