Not everyone with LEMS needs immunosuppression, says Khan.
“But many do, especially people with tumor-related LEMS, which often causes more severe neurological symptoms and may require immunosuppression along with treatment for the underlying cancer,” she says.
“People who take immunosuppressants for LEMS experience a substantial improvement in symptoms of weakness and fatigue,” says David Randall, DO, a neurologist at Advocate Health Care in Park Ridge, Illinois.
The trade-off is that the same treatment that calms the immune attack behind LEMS can also make the immune system less forceful against germs. “The risks are that the immune system will also respond less strongly to infections — and that puts the person at increased risk of mild to severe infections, including lung, kidney, and even brain infections,” says Dr. Randall.
In rare cases, longer or heavier immunosuppression can also increase the risk of certain malignancies, which is why the treatment plan needs to be individualized and closely monitored, says Khan.
“It’s important to be cautious to not reduce the immune system’s function any more than is necessary during treatment,” adds Randall.
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