title: Myasthenia gravis with a paraneoplastic marker.
abstract: Ocular manifestations of myasthenia gravis are very common. Myasthenia gravis may be associated with lung carcinoma. Lambert-Eaton syndrome is also commonly associated with lung carcinoma and can have ocular manifestations. Overlap of these two entities has been described. The case of a patient with fatigable diplopia and ptosis 3 years after removal of a large-cell lung carcinoma is presented. Tests results for acetylcholine receptor binding and modulating antibodies were positive for myasthenia gravis. Test results for presynaptic voltage-gated calcium channel antibodies of the N-type were also positive. However, test results for the P/Q-type voltage-gated calcium channel antibodies, which are consistent with Lambert-Eaton syndrome, were negative. Autoantibodies can be used to serologically distinguish paraneoplastic myasthenia gravis from Lambert-Eaton syndrome.
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Leavitt
mesh_terms: D001323:Autoantibodies / Q000032:analysis; D001379:Azathioprine / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D001763:Blepharoptosis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D015220:Calcium Channels / Q000276:immunology; D018287:Carcinoma, Large Cell / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D004172:Diplopia / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D004359:Drug Therapy, Combination; D004491:Edrophonium; D006801:Humans; D015624:Lambert-Eaton Myasthenic Syndrome / Q000175:diagnosis; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D011241:Prednisone / Q000627:therapeutic use; D011950:Receptors, Cholinergic / Q000276:immunology
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D015220:Calcium Channels; D011950:Receptors, Cholinergic; D004491:Edrophonium; D001379:Azathioprine; D011241:Prednisone