Early diagnosis and successful treatment of paraneoplastic melanocytic proliferation

Joyce C.G. Jansen, Joachim Van Calster, Jose S. Pulido, Sarah L. Miles, Richard G. Vile, Tine Van Bergen, Catherine Cassiman, Leigh H. Spielberg, Anita M. Leys

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)943-948
Number of pages6
JournalBritish Journal of Ophthalmology
Volume99
Issue number7
DOIs
StatePublished - Jul 1 2015

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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    Jansen, J. C. G., Van Calster, J., Pulido, J. S., Miles, S. L., Vile, R. G., Van Bergen, T., Cassiman, C., Spielberg, L. H., & Leys, A. M. (2015). Early diagnosis and successful treatment of paraneoplastic melanocytic proliferation. British Journal of Ophthalmology, 99(7), 943-948. https://doi.org/10.1136/bjophthalmol-2014-305893