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The potential role of plasma exchange as a treatment for bilateral diffuse uveal melanocytic proliferation: A report of two cases
Author(s) -
Jaben Elizabeth A.,
Pulido Jose S.,
Pittock Sean,
Markovic Svetomir,
Winters Jeffrey L.
Publication year - 2011
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.20310
Subject(s) - medicine , retinal detachment , presentation (obstetrics) , cataracts , serous fluid , dermatology , visual acuity , plasmapheresis , surgery , ophthalmology , pathology , retinal , antibody , immunology
Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic syndrome associated with gynecologic malignancies in women and pancreatic or lung carcinomas in men. The clinical presentation consists of the rapid onset of decreased visual acuity due to bilateral serous retinal detachment and cataracts. Pathologically, there is diffuse uveal thickening and proliferation of uveal melanocytes. The onset of blindness is often rapid, with some patients presenting with blindness. We describe the cases of two women with gynecologic malignancies who were treated with plasma exchange (PE) for BDUMP. After a course of five to seven procedures, their ocular disease stabilized. One patient has maintained her vision more than 1 year following the completion of the course of PE. The other patient, who also received treatment with corticosteroids, in addition to the PE, reported stable vision on telephone follow‐up 9 months after presentation. These cases suggest that PE may be a treatment option in this rare paraneoplastic syndrome which has otherwise been reported to invariably result in vision loss. J. Clin. Apheresis, 2011. © 2011 Wiley Periodicals, Inc.