{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:34:04Z","timestamp":1789392844784,"version":"build-2803163510"},"reference-count":24,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,2,28]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>Morvan syndrome (MoS) is a rare paraneoplastic syndrome that is predominantly characterised by autonomic dysfunction, peripheral nerve hyperexcitability and altered mental status. Cases in literature often describe pre-existing autoimmune diagnoses in patients with MoS, alluding to its association with systemic immune dysregulation.<\/jats:p>\n                  <jats:p>We report a woman presenting with hypersomnolence and fluctuating mental status consistent with MoS who had been previously diagnosed with metastatic thymoma, acetylcholine receptor-positive myasthenia gravis and multiple other chronic medical conditions. The report emphasises the importance of prompt recognition of symptoms and accurate diagnosis in rare diseases, allowing for timely initiation of the appropriate immunotherapy that ultimately led to rapid and significant clinical improvement.<\/jats:p>","DOI":"10.1136\/bcr-2025-271140","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:30:31Z","timestamp":1773934231000},"page":"e271140","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Morvan syndrome in a patient with progressing metastatic thymoma and myasthenia gravis"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1638-9095","authenticated-orcid":false,"given":"G\u00fcl\u015fen","family":"\u00d6ztosun","sequence":"first","affiliation":[{"name":"Neurology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Salemme","sequence":"additional","affiliation":[{"name":"Medicine, Johns Hopkins Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry J","family":"Kaminski","sequence":"additional","affiliation":[{"name":"Neurology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4875-3282","authenticated-orcid":false,"given":"Sarah T","family":"Conway","sequence":"additional","affiliation":[{"name":"Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"2026031908301917000_19.3.e271140.1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23577"},{"key":"2026031908301917000_19.3.e271140.2","unstructured":"Masood W , Lui F , Sitammagari KK . Morvan syndrome. In: StatPearls. Treasure Island (FL), 2025."},{"key":"2026031908301917000_19.3.e271140.3","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1097\/CND.0b013e31822b1977","article-title":"Morvan syndrome: a case report and review of the literature","volume":"13","author":"Abou-Zeid","year":"2012","journal-title":"J Clin Neuromuscul Dis"},{"key":"2026031908301917000_19.3.e271140.4","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000978"},{"key":"2026031908301917000_19.3.e271140.5","doi-asserted-by":"crossref","first-page":"2716","DOI":"10.3892\/ol.2016.4922","article-title":"Paraneoplastic Morvan\u2019s syndrome following surgical treatment of recurrent thymoma: A case report","volume":"12","author":"Gali\u00e9","year":"2016","journal-title":"Oncol Lett"},{"key":"2026031908301917000_19.3.e271140.6","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1111\/ene.13922","article-title":"Acquired neuromyotonia in thymoma-associated myasthenia gravis: a clinical and serological study","volume":"26","author":"Gastaldi","year":"2019","journal-title":"Eur J Neurol"},{"key":"2026031908301917000_19.3.e271140.7","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1007\/s10072-018-3515-y","article-title":"Morvan\u2019s syndrome-is a pathogen behind the curtain?","volume":"39","author":"Singh","year":"2018","journal-title":"Neurol Sci"},{"key":"2026031908301917000_19.3.e271140.8","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2022.1002808","article-title":"Case report: Complex paraneoplastic syndromes in thymoma with nephrotic syndrome, cutaneous amyloidosis, myasthenia gravis, and Morvan\u2019s syndrome","volume":"12","author":"Liu","year":"2022","journal-title":"Front Oncol"},{"key":"2026031908301917000_19.3.e271140.9","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s10354-021-00904-z","article-title":"Delirium in geriatric patients","volume":"172","author":"Iglseder","year":"2022","journal-title":"Wien Med Wochenschr"},{"key":"2026031908301917000_19.3.e271140.10","doi-asserted-by":"crossref","first-page":"577","DOI":"10.4103\/0976-3147.188638","article-title":"Morvan\u2019s syndrome with anti contactin associated protein like 2 - voltage gated potassium channel antibody presenting with syndrome of inappropriate antidiuretic hormone secretion","volume":"7","author":"Sharma","year":"2016","journal-title":"J Neurosci Rural Pract"},{"key":"2026031908301917000_19.3.e271140.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-009-0041-y"},{"key":"2026031908301917000_19.3.e271140.12","first-page":"612","article-title":"Morvan\u2019s Syndrome with Myasthenia Gravis: An Autoimmune or Paraneoplastic Association?","volume":"27","author":"Menon","year":"2024","journal-title":"Ann Indian Acad Neurol"},{"key":"2026031908301917000_19.3.e271140.13","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjab636","article-title":"Extrapleural pneumonectomy for recurrent thymoma diagnosed after return of paraneoplastic Morvan syndrome","volume":"2022","author":"Banks","year":"2022","journal-title":"J Surg Case Rep"},{"key":"2026031908301917000_19.3.e271140.14","doi-asserted-by":"crossref","DOI":"10.3389\/fnhum.2025.1658933","article-title":"Case Report: When multiple system atrophy masquerades as CASPR2 autoimmune encephalopathy: a diagnostic pitfall","volume":"19","author":"Zhang","year":"2025","journal-title":"Front Hum Neurosci"},{"key":"2026031908301917000_19.3.e271140.15","unstructured":"Suchy HVW . Dylan Morvan syndrome: rare or underdiagnosed?. Royal College of Surgeons in Ireland, 2023."},{"key":"2026031908301917000_19.3.e271140.16","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/NRL.0000000000000097","article-title":"Fatal Morvan Syndrome Associated With Myasthenia Gravis","volume":"22","author":"Nagappa","year":"2017","journal-title":"Neurologist"},{"key":"2026031908301917000_19.3.e271140.17","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-010-0130-z"},{"key":"2026031908301917000_19.3.e271140.18","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.nmd.2022.06.001","article-title":"Refractory Morvan syndrome responsive to rituximab: a case report and review of the literature","volume":"32","author":"Nawfal","year":"2022","journal-title":"Neuromuscul Disord"},{"key":"2026031908301917000_19.3.e271140.19","doi-asserted-by":"crossref","DOI":"10.1016\/j.jneuroim.2020.577197","article-title":"Mercury-induced autoimmunity: Report of two adolescent siblings with Morvan syndrome \u201cplus\u201d and review of the literature","volume":"342","author":"P\u00e9rez","year":"2020","journal-title":"J Neuroimmunol"},{"key":"2026031908301917000_19.3.e271140.20","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/NRL.0000000000000266","article-title":"Morvan Syndrome and Diffuse Large B-Cell Lymphoma in the Central Nervous System","volume":"25","author":"Jiang","year":"2020","journal-title":"Neurologist"},{"key":"2026031908301917000_19.3.e271140.21","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-226832","article-title":"Morvan\u2019s syndrome treated successfully with rituximab and lacosamide","volume":"12","author":"Sveinsson","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2026031908301917000_19.3.e271140.22","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s00415-025-13088-y","article-title":"Successful treatment of morvan syndrome with efgartigimod: report of two cases","volume":"272","author":"Wang","year":"2025","journal-title":"J Neurol"},{"key":"2026031908301917000_19.3.e271140.23","doi-asserted-by":"crossref","DOI":"10.1111\/ene.70285","article-title":"Unmasking Anti-CASPR2 Syndrome in a Patient Treated for Myasthenia Gravis in the Era of New Treatments","volume":"32","author":"Fabry","year":"2025","journal-title":"Eur J Neurol"},{"key":"2026031908301917000_19.3.e271140.24","doi-asserted-by":"crossref","DOI":"10.12659\/AJCR.947004","article-title":"Exploring Telitacicept for Neurological Autoimmune Disorders: A Case Study on Morvan Syndrome","volume":"26","author":"Fu","year":"2025","journal-title":"Am J Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-271140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:30:34Z","timestamp":1773934234000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-271140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,19]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bcr-2025-271140"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-271140","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}