title: [Severe necrotizing myopathy subsequent to Merkel cell carcinoma].
abstract: BACKGROUND
  Merkel cell carcinoma (MCC) is a rare tumour with a poor prognosis. Rare cases of paraneoplastic neurological syndrome have been associated with this type of tumour, namely myasthenic syndrome of Lambert-Eaton and encephalomyelitis. We report the first case of severe necrotizing myopathy with anti-Hu antibodies complicating MCC.
  
  
  METHODS
  We describe the case of a 58-year-old woman with Merkel cell carcinoma (MCC) of the forearm complicated by severe necrotizing myopathy associated with the presence of anti-Hu antibodies. This myopathy occurred 3 months after complete remission of MCC. The patient was treated with high-dose corticosteroids combined with two intravenous infusions of immunoglobulins. Her neurological status deteriorated despite this treatment. Pararaneoplastic syndrome (anti-Hu antibodies, necrotizing myopathy) complicating MCC was suspected. There was no visible tumour relapse. After multidisciplinary discussion, it was decided to supplement treatment with chemotherapy (carboplatin and VP-16). The patient died 20 days after the first course of chemotherapy.
  
  
  CONCLUSIONS
  Severe necrotizing myopathy with anti-Hu antibodies may be added to the list of possible paraneoplastic syndromes associated with Merkel cell carcinoma.
authors.affiliation: Service de dermatologie, hôpital Henri-Mondor, 51, avenue du Maréchal-De-Lattre-De-Tassigny, 94010 Créteil cedex, France. ouafahocar@yahoo.com
authors.forename: O
authors.initials: O
authors.lastname: Hocar
authors.forename: E
authors.initials: E
authors.lastname: Poszepczynska-Guigné
authors.forename: O
authors.initials: O
authors.lastname: Faye
authors.forename: J
authors.initials: J
authors.lastname: Wechsler
authors.forename: M
authors.initials: M
authors.lastname: Bagot
authors.forename: V
authors.initials: V
authors.lastname: Buffard
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001323:Autoantibodies; D001706:Biopsy; D015266:Carcinoma, Merkel Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003131:Combined Modality Therapy; D051959:ELAV Proteins / Q000276:immunology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007116:Immunization, Passive; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D009135:Muscular Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D009336:Necrosis; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
chemical_list: D001323:Autoantibodies; D051959:ELAV Proteins