Document Detail

Therapy for paraneoplastic neurologic syndromes in six patients with protein A column immunoadsorption.
MedLine Citation:
PMID:  8826927     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Paraneoplastic neurologic syndromes, although rare, cause significant morbidity and mortality. They are thought to be immunologically mediated, but to date those involving the central nervous system (CNS) have not been particularly responsive to immunologic therapy. The use of the novel immunomodulator, protein A immunoadsorption, was explored to address this question. METHODS: Six patients with neurologic paraneoplastic syndromes were treated with this technique, using the "off line" method. Two hundred fifty ml of plasma was perfused through a column containing protein A covalently attached to a silica matrix. The plasma was then returned to the patient. RESULTS: Five of the patients responded to the therapy, with complete and durable responses in three patients with opsoclonus-myoclonus, objective, though transient, improvement in one patient with paraneoplastic brainstem encephalitis associated with a Merkel cell tumor, and stabilization and partial improvement in one patient with paraneoplastic limbic encephalitis. The patient without response developed a cutaneous vasculitis after the second treatment, and therapy was discontinued. CONCLUSIONS: This therapy appears beneficial for a number of paraneoplastic syndromes, most dramatically in the opsoclonus/myoclonus syndrome.
L M Cher; F H Hochberg; J Teruya; M Nitschke; R F Valenzuela; J D Schmahmann; M Herbert; H D Rosas; C Stowell
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cancer     Volume:  75     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  1995 Apr 
Date Detail:
Created Date:  1996-11-06     Completed Date:  1996-11-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1678-83     Citation Subset:  AIM; IM    
Department of Neurology, Massachusetts General Hospital, Boston 02114, USA.
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MeSH Terms
Cerebellar Diseases / therapy*
Encephalitis / therapy*
Immunosorbent Techniques*
Middle Aged
Myoclonus / therapy*
Ocular Motility Disorders / therapy*
Paraneoplastic Syndromes / therapy*
Staphylococcal Protein A / therapeutic use*
Reg. No./Substance:
0/Staphylococcal Protein A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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