Isolated dysphagia due to paraneoplastic myasthenic syndrome with anti-P/Q-type voltage-gated calcium-channel and anti-acetylcholine receptor antibodies.
Dysphagia is a common symptom in neuromuscular junction disorders, but it rarely occurs in isolation or is the presenting feature. We describe a patient presenting with isolated dysphagia to liquids. Electrophysiological studies, such as repetitive nerve stimulation and single-fiber electromyography, were normal. Serum anti-P/Q-type voltage-gated calcium-channel (anti-P/Q-type VGCC) and anti-acetylcholine receptor (AChR ab) antibodies were above the normal range. A computed tomography scan showed a mediastinal mass corresponding to a thymic carcinoma. After chemotherapy, surgical removal of the thymic carcinoma and radiotherapy, the patient no longer complained of dysphagia, AChR ab titers were reduced and anti-P/Q-type VGCC antibodies became negative. To the best of our knowledge, no previous reports of a paraneoplastic myasthenic syndrome related to thymic carcinoma with both anti-P/Q-type VGCC and AChR antibodies have been described.
Department of Neurology, Clínica Universidad de Navarra, Avda. Pio XII 36, 31008 Pamplona, Spain.
Roberto
R
Fernandez-Torron
Juan
J
Arcocha
Jose M
JM
López-Picazo
Javier
J
Pardo
Maria Akiko
MA
Tamura
Cristina
C
Carretero
Pau
P
Pastor
D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D020865:Calcium Channels, P-Type / Q000276:immunology*; D020907:Calcium Channels, Q-Type / Q000276:immunology*; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D004576:Electromyography; D006801:Humans; D015624:Lambert-Eaton Myasthenic Syndrome / Q000150:complications* / Q000276:immunology; D008297:Male; D009469:Neuromuscular Junction / Q000503:physiopathology; D010257:Paraneoplastic Syndromes / Q000150:complications* / Q000276:immunology; D011950:Receptors, Cholinergic / Q000276:immunology*; D013953:Thymus Neoplasms / Q000150:complications / Q000276:immunology / Q000628:therapy; D014057:Tomography, X-Ray Computed
D000888:Antibodies, Anti-Idiotypic; D020865:Calcium Channels, P-Type; D020907:Calcium Channels, Q-Type; D011950:Receptors, Cholinergic