LEMS advantage

Q: What makes Lambert-Eaton myasthenic syndrome (LEMS) a disease of advantage?

Answer:  Anytime a patient presents with Lambert-Eaton myasthenic syndrome (LEMS), the first priority should be to look for small cell lung cancer (SCLC) due to a strong association of almost half of the cases. This association becomes more strong with the history of smoking. LEMS usually manifests in the early part of the SCLC and gives an advantage for the more effective treatment for cancer.

 It is also found to be associated with lymphoproliferative disorders though less likely. 

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References:

1. Wirtz PW, Lang B, Graus F, et al. P/Q-type calcium channel antibodies, Lambert-Eaton myasthenic syndrome and survival in small cell lung cancer. J Neuroimmunol 2005; 164:161. 

2. Payne M, Bradbury P, Lang B, et al. Prospective study into the incidence of Lambert Eaton myasthenic syndrome in small cell lung cancer. J Thorac Oncol 2010; 5:34. 

3. Lemal R, Chaleteix C, Minard P, et al. Large granular lymphocytic leukemia associated with Lambert-Eaton Myasthenic Syndrome: A case report. Leuk Res Rep 2013; 2:32. 

4. Siau RT, Morris A, Karoo RO. Surgery results in complete cure of Lambert-Eaton myasthenic syndrome in a patient with metastatic Merkel cell carcinoma. J Plast Reconstr Aesthet Surg 2014; 67:e162. 

5. Nalbantoglu M, Kose L, Uzun N, et al. Lambert-Eaton myasthenic syndrome associated with thymic neuroendocrine carcinoma. Muscle Nerve 2015; 51:936.