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Plasma Exchange-Responsive Bulbar Dysfunction in Thymoma-Associated Myasthenia Gravis with Concomitant Lambert-Eaton Myasthenic Syndrome

Year: 2026

Type: article

Abstract: The coexistence of thymoma-associated myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) is rare, and no established therapeutic strategy exists for this condition. We herein report a case of MG-LEMS overlap syndrome (MLOS) in which plasma exchange (PE) effectively treated severe bulbar dysfunction refractory to intravenous immunoglobulin (IVIg). Sequential electrophysiological testing demonstrated an improvement in the low compound muscle action potential amplitudes and post-exercise increments, reflecting LEMS activity. This case highlights that PE may be more efficacious than IVIg for bulbar symptoms in MLOS, particularly with prominent presynaptic involvement, and supports electrophysiological assessment to guide treatment.

Source: Internal Medicine

DOI: 10.2169/internalmedicine.7609-26

Authors: Ryuichiro Hayashi, Takashi Hosaka, Makoto Terada, Shinji Saiki

Institutions: University of Tsukuba, Ibaraki Prefectural Central Hospital

Language: English

Topic: Myasthenia Gravis and Thymoma

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7203666430

FWCI:

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