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No clinical improvement: case report A 72-year-old woman exhibited no clinical improvement during treatment with carboplatin, etoposide, methylprednisolone sodium succinate and immune globulin for small cell lung cancer [dosages not stated; not all routes stated]. The woman presented with constipation and vomiting. Following admission, she developed dysesthesias and allodynia in the hands. Following examination, asymmetric distal >proximal sensory loss in the upper extremities, pseudo-athetosis and areflexia were noted. She also had signs of an axonal non-length dependent sensory and motor neuropathy. Further investigations indicated a limited stage small cell lung cancer. Therefore, she started receiving carboplatin, etoposide and IV methylprednisolone sodium succinate [solumedrol] followed by IV immune globulin [IVIG]. She received 2 cycles of chemotherapy with carboplatin and etoposide. Despite all these therapies, her condition did not improve. Due to further worsening of functional status, the decision was made to transfer to hospice. Based on the clinical presentation, intestinal pseudo-obstruction as the presenting symptom of an Anti-Hu mediated paraneoplastic syndrome associated with small cell lung cancer was confirmed. Roy-Hewitson C, et al. Paraneoplastic intestinal pseudoobstruction as the presenting symptom of a lung malignancy in an elderly woman. European Journal of Neurology 27 803498682 (Suppl. 1): 1193 abstr. EPO3292, May 2020. Available from: URL: https://onlinelibrary.wiley.com/doi/10.1111/ene.14308 [abstract]

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Reactions 29 Aug 2020 No. 1819