Tomoko Okazaki    Department   Kawasaki Medical School  Kawasaki Medical School, Department of Stroke Medicine,    Position
Article types	症例報告
Language	English
Peer review	Peer reviewed
Title	Lambert-Eaton Myasthenic Syndrome Caused by Nivolumab in a Patient with Squamous Cell Lung Cancer.
Journal	Formal name：Case reports in neurology Abbreviation：Case Rep Neurol ISSN code：1662680X/1662680X
Domestic / Foregin	Domestic
Volume, Issue, Page	10(3),pp.346-352
Author and coauthor	Yuki Nakatani, Natsuki Tanaka, Tomomi Enami, Seigo Minami, Tomoko Okazaki, Kiyoshi Komuta
Publication date	2018
Summary	Lambert-Eaton myasthenic syndrome (LEMS) is a representative paraneoplastic neurological syndrome. Recently, nivolumab, an anti-programmed cell death 1 inhibitor, has been approved for advanced non-small-cell lung cancer. Careful attention should be paid to immune-related adverse events (irAEs), including neurotoxicity. We herein report a 73-year-old woman with LEMS that occurred during nivolumab treatment for pulmonary squamous cell carcinoma. After the 20th week of nivolumab, she experienced various neurological symptoms such as ptosis, lower limb weakness, and photophobia. Findings from a nerve conduction study and a positive anti-P/Q-type voltage-gated calcium channel antibody made a diagnosis of LEMS. Pyridostigmine and 3,4-diaminopyridine temporarily improved her symptoms. This was the first case of LEMS as a neurological irAE. LEMS should be considered as a possible neurological irAE.
DOI	10.1159/000494078
PMID	30627102