Lambert-Eaton myasthenic syndromeとsubacute cerebellar degenerationを伴った肺小細胞癌の1例—本邦報告例の臨床的検討

Report of a Case of Small Cell Lung Cancer Associated with Lambert-Eaton Myasthenic Syndrome and Subacute Cerebellar Degeneration: With a Review of the Japanese Literature

　Lambert-Eaton myasthenic syndrome（LEMS）とsubacute cerebellar degeneration（SCD）を合併した肺小細胞癌の1例を報告した。症例は71歳男性で，四肢の脱力で発症し，まもなく測定障害，協調運動障害，構語障害などの小脳症状が出現した。血清抗電位依存性カルシウムチャンネル抗体価は陽性であった。入院後行った血漿交換療法および腫瘍発見後行った化学療法によりLEMSの症状は改善を認めたが，SCDの症状は緩徐進行性で治療効果を認めなかった。Paraneoplastic syndromeとしてのLEMSとSCDの両者の合併例の報告は少なく，臨床症状や治療効果について本邦例の文献的考察を加えて報告した。

We report a patient with small cell lung cancer associated with Lambert-Eaton myasthenic syn-drome (LEMS) and subacute cerebellar degenera-tion (SCD). The patient was a 71-year old man suffering from weakness of the limbs and a gait disturbance who developed limb ataxia and dysarth-ria one month after admission. Electrophysiologic studies confirmed the diagnosis of Lambert- Eaton myasthenic syndrome. Chest X-rays 2 months after admission revealed an abnormal shadow, and small cell lung cancer was diagnosed on the basis of biopsy specimens. Anti-voltage-gated calcium channel antibody was positive.