Early Induction of IVIg Improved the Performance Status and Enabled Chemotherapy Initiation in PCD-LEMS: A Case Report
Abstract
A 73-year-old man developed progressive gait disturbance and diplopia over two weeks concomitant with rapidly enlarging pulmonary lesions. Examination revealed proximal lower limb weakness, diminished deep tendon reflexes, ataxic dysarthria, limb and truncal ataxia, and orthostatic hypotension. Nerve conduction studies revealed reduced compound muscle action potentials with postexercise facilitation. Elevated anti-P/Q-type voltage-gated calcium channel antibodies confirmed paraneoplastic cerebellar degeneration (PCD) with Lambert-Eaton myasthenic syndrome (LEMS). Bronchoscopy revealed small-cell lung cancer. Although a poor performance status (PS) initially precluded chemotherapy, high-dose intravenous immunoglobulin therapy improved the PS, enabling cancer treatment. Immunotherapy should be considered when a PCD-LEMS-related poor PS prevents cancer therapy.
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BibTeX
@article{tanaka2026early,
title = {{Early Induction of IVIg Improved the Performance Status and Enabled Chemotherapy Initiation in PCD-LEMS: A Case Report}},
author = {Tomohiro Tanaka and Akihiro Kitamura and Ryota Tamura and Takahito Tsukamoto and Hiroyuki Yabata and Shuhei Kobashi and Yoshitaka Tamaki and Nobuhiro Ogawa and Isamu Yamakawa and Makoto Urushitani},
journal = {Internal Medicine},
year = {2026},
month = aug,
doi = {10.2169/internalmedicine.7251-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7251-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Early Induction of IVIg Improved the Performance Status and Enabled Chemotherapy Initiation in PCD-LEMS: A Case Report
AU - Tomohiro Tanaka
AU - Akihiro Kitamura
AU - Ryota Tamura
AU - Takahito Tsukamoto
AU - Hiroyuki Yabata
AU - Shuhei Kobashi
AU - Yoshitaka Tamaki
AU - Nobuhiro Ogawa
AU - Isamu Yamakawa
AU - Makoto Urushitani
PY - 2026
DA - 2026/08/19
JO - Internal Medicine
DO - 10.2169/internalmedicine.7251-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7251-26/_article
AB - A 73-year-old man developed progressive gait disturbance and diplopia over two weeks concomitant with rapidly enlarging pulmonary lesions. Examination revealed proximal lower limb weakness, diminished deep tendon reflexes, ataxic dysarthria, limb and truncal ataxia, and orthostatic hypotension. Nerve conduction studies revealed reduced compound muscle action potentials with postexercise facilitation. Elevated anti-P/Q-type voltage-gated calcium channel antibodies confirmed paraneoplastic cerebellar degeneration (PCD) with Lambert-Eaton myasthenic syndrome (LEMS). Bronchoscopy revealed small-cell lung cancer. Although a poor performance status (PS) initially precluded chemotherapy, high-dose intravenous immunoglobulin therapy improved the PS, enabling cancer treatment. Immunotherapy should be considered when a PCD-LEMS-related poor PS prevents cancer therapy.
SN - 1349-7235
SN - 0918-2918
ER -