Early diagnosis and successful treatment of paraneoplastic melanocytic proliferation

Autor: Sarah L. Miles, J Jansen, Richard G. Vile, Catherine Cassiman, Jose S. Pulido, Anita Leys, Tine Van Bergen, Joachim Van Calster, Leigh Spielberg
Rok vydání: 2014
Předmět:
Male
Vascular Endothelial Growth Factor A
Pathology
Lung Neoplasms
medicine.medical_treatment
Visual Acuity
Angiogenesis Inhibitors
Imaging
Fluorescein Angiography
Progressive visual loss
Subretinal Fluid
Plasmapheresis
Clinical Science
Combined Modality Therapy
Sensory Systems
Bevacizumab
Vascular endothelial growth factor A
medicine.anatomical_structure
Lymphatic Metastasis
Intravitreal Injections
Adenocarcinoma
Melanocytes
Tomography
Optical Coherence
medicine.drug
medicine.medical_specialty
Antineoplastic Agents
Melanocyte
Antibodies
Monoclonal
Humanized
Retina
Cellular and Molecular Neuroscience
medicine
Humans
Aged
Cell Proliferation
Chemotherapy
Neoplasia
business.industry
Paraneoplastic Syndromes
Ocular
Choroid
medicine.disease
Ophthalmology
Early Diagnosis
Visual Field Tests
Visual Fields
business
Zdroj: The British Journal of Ophthalmology
ISSN: 1468-2079
Popis: Background Paraneoplastic melanocytic proliferation (bilateral diffuse uveal melanocytic proliferation, BDUMP) is a rare but devastating disease that causes progressive visual loss in patients who usually have an occult malignancy. Visual loss occurs as a result of paraneoplastic changes in the uveal tissue. Methods In a masked fashion, the serum of two patients with BDUMP was evaluated for the presence of cultured melanocyte elongation and proliferation (CMEP) factor using cultured human melanocytes. We evaluated the efficacy of plasmapheresis as a treatment modality early in the disease in conjunction with radiation and chemotherapy. Results The serum of the first case patient was investigated after plasmapheresis and did not demonstrate proliferation of cultured human melanocytes. The serum of the second case was evaluated prior to treatment with plasmapheresis and did induce this proliferation. These findings are in accordance with the diminution of CMEP factor after plasmapheresis. Treatment with plasmapheresis managed to stabilise the ocular disease progression in both patients. Conclusions In the past, visual loss due to paraneoplastic melanocytic proliferation was considered progressive and irreversible. We treated two patients successfully with plasmapheresis and demonstrated a relation between CMEP factor in the serum of these patients and proliferation of cultured melanocytes.
Databáze: OpenAIRE
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