Neurogenic bladder in Lambert–Eaton myasthenic syndrome and its response to 3,4-diaminopyridine

Satoh, Katsuya; Motomura, Masakatsu; Suzu, H; Nakao, Yoshio; Fujimoto, Takeshi; Fukuda, Toyoki; Nakane, Shunya; Nakamura, Tatsufumi; Eguchi, Katsumi

doi:10.1016/s0022-510x(00)00460-3

Cited by 6 publications

(2 citation statements)

References 22 publications

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“…concluded that voiding dysfunction heralded either a new diagnosis of myasthenia gravis or an exacerbation of the disease process ( 28 ). The Lambert–Eaton myasthenic syndrome is characterized by autonomic dysfunction, which is also experienced as voiding dysfunction in some cases ( 29 ). Inflammatory myopathies can also affect bladder/urinary function by decreasing pelvic floor function ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Urinary incontinence as a possible signal of neuromuscular toxicity during immune checkpoint inhibitor treatment: Case report and retrospective pharmacovigilance study

Lu²,

Tang³

et al. 2022

Front. Oncol.

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BackgroundImmune checkpoint inhibitors (ICIs) are associated with different immune-related adverse events (irAEs), but there is limited evidence regarding the association between urinary incontinence and ICIs.MethodsWe described the case of a patient experiencing urinary incontinence who later experienced a series of irAEs such as myocarditis, myositis, and neurologic diseases while on ICI treatment in our hospital. In addition, we queried the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) from the third quarter of 2010 to the third quarter of 2020 to perform a retrospective study to characterize the clinical features of urinary incontinence associated with ICIs.ResultIn the FAERS study, 59 cases of ICI-related urinary incontinence were retrieved, and approximately 32.2% of the cases were fatal. Combination therapy with nervous system drugs and age >80 years old were the significant risk factors for fatal outcomes. Among these cases of ICI-related urinary incontinence, 40.7% (n = 24) occurred concomitantly with other adverse events, especially, neurological (fifteen cases), cardiovascular (seven cases), musculoskeletal (six cases), and urological disorders (five cases). Five cases had an overlapping syndrome similar to our case report, including one case of myasthenia gravis with myocarditis and another of myasthenic syndrome with polymyositis.ConclusionICI-related urinary incontinence might be a signal of fatal neuromuscular irAEs, especially when it occurs concomitantly with ICI-associated neuromuscular–cardiovascular syndrome. Clinicians should be aware of the occurrence of urinary incontinence to identify potentially lethal irAEs in the early phase.

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Section: Discussionmentioning

confidence: 99%

Urinary incontinence as a possible signal of neuromuscular toxicity during immune checkpoint inhibitor treatment: Case report and retrospective pharmacovigilance study

Lu²,

Tang³

et al. 2022

Front. Oncol.

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“…Therefore, a direct effect is possible through a blockade of muscular potassium channels, leading to an increased excitability of the detrusor muscle by which urinary flow rate can increase and residual volume decrease. Second, the detrusor muscle is innervated by autonomic parasympathetic nerves via acetylcholine [ 9 ]. Aminopyridines are known to increase the release of different neurotransmitters, including acetylcholine, noradrenaline, dopamine, and serotonin; all closely related to the autonomic nervous system [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

4-Aminopyridine Improves Lower Urinary Tract Symptoms in a Patient With Benign Prostatic Hyperplasia and Downbeat Nystagmus Syndrome

et al. 2014

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Aminopyridines are potassium channel blockers that increase the excitability of nerve cells and axons; therefore, they are widely used to treat different neurological disorders. Here we present a patient with idiopathic downbeat nystagmus and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia who was treated with the sustained-release form of 4-aminopyridine (4-AP). During treatment with 4-AP, the LUTS improved. This improvement was monitored by using uroflowmetry and the International Prostate Symptom Score. A significant improvement of symptoms was observed in relation to the voided volume. This included an improved emptying of the bladder without an increase in residual urine. In animal studies, both nonselective K+ channel blockade and selective voltage-sensitive potassium blockade by 4-AP resulted in increased contraction on rat detrusor strips. To our knowledge, this is the first clinical observation of the mode of action of 4-AP in urological symptoms in humans.

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Spinal Muscular Atrophy/Lambert Eaton Myasthenic Syndrome

Vurture

Peyronnet

Brucker

2019

Urological Care for Patients With Progressive Neurological Conditions

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Neurogenic bladder in Lambert–Eaton myasthenic syndrome and its response to 3,4-diaminopyridine

Cited by 6 publications

References 22 publications

Urinary incontinence as a possible signal of neuromuscular toxicity during immune checkpoint inhibitor treatment: Case report and retrospective pharmacovigilance study

Urinary incontinence as a possible signal of neuromuscular toxicity during immune checkpoint inhibitor treatment: Case report and retrospective pharmacovigilance study

4-Aminopyridine Improves Lower Urinary Tract Symptoms in a Patient With Benign Prostatic Hyperplasia and Downbeat Nystagmus Syndrome

Spinal Muscular Atrophy/Lambert Eaton Myasthenic Syndrome

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