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 |
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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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