Acute Respiratory Failure Resulting From Lambert-Eaton Myasthenic Syndrome: A Case Report and Literature Review.

Publication/Presentation Date

5-1-2024

Abstract

Lambert-Eaton myasthenic syndrome (LEMS) is a rare neuromuscular junction disorder due to auto-antibodies against presynaptic voltage-gated calcium channels (VGCC). The typical manifestation of LEMS is proximal muscle weakness, autonomic dysfunction, and areflexia; however, an atypical manifestation of LEMS is weakness of respiratory muscles, leading to acute respiratory failure. Herein, we describe a case of acute respiratory failure resulting from LEMS. Our patient was a 63-year-old woman with a past medical history of metastatic small cell lung cancer (SCLC) who presented with ambulatory dysfunction, dysarthria, and progressive dyspnea. She was intubated because of hypoxia and developed acute respiratory failure without a clear pulmonary etiology, raising the suspicion of a neuromuscular junction disorder. She was diagnosed with LEMS with a positive paraneoplastic panel for VGCC antibodies, confirmed by electromyography and nerve conduction study (EMG/NCS), and treated with intravenous immunoglobulin (IVIg). The patient's hospital stay was complicated by pneumonia, and comfort care was ultimately pursued. Our case highlights the importance of considering LEMS in patients presenting with isolated respiratory muscle weakness without focal neurological deficits. To our knowledge, this is the first report to review all reported cases of LEMS with resultant respiratory failure. We aim to establish the association of LEMS with respiratory failure so that appropriate treatment is initiated as early as possible.

Volume

16

Issue

5

First Page

59516

Last Page

59516

ISSN

2168-8184

Disciplines

Medicine and Health Sciences

PubMedID

38826943

Department(s)

USF-LVHN SELECT Program, USF-LVHN SELECT Program Faculty, USF-LVHN SELECT Program Students, Department of Medicine, Department of Medicine Fellows and Residents, Fellows and Residents

Document Type

Article

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