Transient Lambert-Eaton myasthenic syndrome associated with systemic lupus erythematosus.
We present a patient who developed the Lambert-Eaton myasthenic syndrome (LEMS) in association with systemic lupus erythematosus (SLE). Severe proximal weakness with electrodiagnostic evidence of LEMS developed over 2 days during an exacerbation of cutaneous manifestations (bullous pemphigoid) associated with SLE. Following an increase in the daily dose of prednisone, there was complete clinical restitution of strength within 2 weeks and a slower resolution of electrodiagnostic abnormalities over 6 months. Marked serologic abnormalities were present at the onset and showed improvement over 6-8 months. LEMS had been infrequently described in association with SLE. The immunologic features of both SLE and LEMS suggest a linkage between the two diseases in this patient. We hypothesize that increased antibodies associated with exacerbation of SLE cross reacted with the neuromuscular junction membrane to produce LEMS.
Bromberg
M B
MB
Department of Neurology, University of Michigan, Ann Arbor.
Albers
J W
JW
McCune
W J
WJ
D000328:Adult; D001327:Autoimmune Diseases / Q000503:physiopathology*; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology*; D009135:Muscular Diseases / Q000503:physiopathology*; D009369:Neoplasms / Q000503:physiopathology; D009469:Neuromuscular Junction / Q000502:physiology; D013577:Syndrome