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

• Published in: Internal Medicine Vol. 62; no. 7; pp. 0072-22 - 1058
• Main Authors: Takigawa, Yuki, Watanabe, Hiromi, Omote, Yoshio, Kurihara, Sunao, Inoue, Tomoyoshi, Fujiwara, Miho, Mitsumune, Sho, Onishi, Kiriko, Kudo, Kenichiro, Sato, Akiko, Sato, Ken, Fujiwara, Keiichi, Shibayama, Takuo
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-04-2023; Japan Science and Technology Agency
• Subjects: Aged; Calcium channels (voltage-gated); Carcinoma, Non-Small-Cell Lung - complications; Carcinoma, Non-Small-Cell Lung - drug therapy; Case Report; Channel gating; Electromyography; Female; Humans; immune checkpoint inhibitor; Immune checkpoint inhibitors; immune-related adverse event; Internal medicine; Lambert-Eaton myasthenic syndrome; Lambert-Eaton Myasthenic Syndrome - chemically induced; Lambert-Eaton Myasthenic Syndrome - diagnosis; Lambert-Eaton Myasthenic Syndrome - drug therapy; Lung Neoplasms - complications; Neuromuscular junctions; non-small cell lung cancer; Non-small cell lung carcinoma; Pembrolizumab; Remission; Small Cell Lung Carcinoma - complications; immune checkpoint inhibitor; Lambert-Eaton myasthenic syndrome; immune-related adverse event; non-small-cell lung cancer
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.0072-22

A 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.