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Therapeutic plasma exchange for a case of refractory opsoclonus myoclonus ataxia syndrome
Author(s) -
Greensher Jocelyn E.,
Louie James,
Fish Jonathan D.
Publication year - 2018
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26819
Subject(s) - medicine , rituximab , asymptomatic , prednisolone , refractory (planetary science) , neuroblastoma , ataxia , surgery , pediatrics , oncology , lymphoma , psychiatry , physics , astrobiology , biology , genetics , cell culture
Abstract Opsoclonus myoclonus ataxia syndrome (OMAS) can be refractory to standard therapies and devastating. Alternative treatments are imperative. A 14‐month‐old male diagnosed with neuroblastoma and paraneoplastic OMAS achieved complete cancer remission with chemotherapy. The OMAS, however, persisted over the subsequent 4 years despite numerous immune‐modulatory and immunosuppressive therapies. The patient ultimately achieved complete remission following therapeutic plasma exchange (TPE) combined with rituximab and intravenous immunoglobulin. After three asymptomatic years, he relapsed. Upon reintroducing TPE and rituximab plus oral prednisolone, the patient rapidly achieved a second complete remission. This case offers proof‐of‐principle for the potential efficacy of TPE for neuroblastoma‐associated OMAS.