An elderly women case of ...

A 60-year-old female presented with a one-month history of non-productive cough, initially diagnosed as miliary tuberculosis based on CT chest findings. She commenced anti-tubercular treatment (ATT), although sputum results were negative. After a week, she developed weakness in all four limbs and the head, prompting admission. On examination, hypotonic weakness graded at 3/5 was noted in all four limbs with absent reflexes. A follow-up CT chest revealed a right upper lobe mass, confirmed as small cell carcinoma through EBUS. Despite normal findings in MRI of the brain, cervical spine, and CSF analysis, Lambert-Eaton myasthenia syndrome was suspected. Nerve conduction studies and nerve stimulation tests confirmed an increment response. The patient initiated chemotherapy and plasmapheresis, marking a unique case of small cell carcinoma with Lambert-Eaton myasthenia syndrome.