Anti-Ri antibody positive opsoclonus-myoclonus in a male patient with breast carcinoma

Wirtz, Paul W.; Hoff, Jorrit I.; Leeuw, Bertie de; Lammers, Gert Jan; Duinen, Sjoerd G. van; Verschuuren, Jan J.

doi:10.1007/s00415-002-0913-z

Cited by 28 publications

(20 citation statements)

References 15 publications

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“…Opsoclonus is often associated with diffuse or focal myoclonus, the "dancing eyes and dancing feet syndrome," and other cerebellar and brainstem signs [28,53,54]. An excessive startle response reminiscent of hyperekplexia may also occur The Oncologist ® in opsoclonus-myoclonus patients [55]. In contrast to most PNS, the course of opsoclonus-myoclonus may be remitting and relapsing [54].…”

Section: Opsoclonus-myoclonusmentioning

confidence: 99%

“…The most commonly associated neoplasms are SCLC and breast and gynecologic cancers [55,56]. Many other tumors, including thyroid and bladder cancer, have also been reported [57].…”

Section: Underlying Tumormentioning

confidence: 99%

“…However, improvement following the administration of steroids, cyclophosphamide, azathioprine, i.v. Ig, plasma exchange, or plasma filtration with a protein A column has been described in single cases [55,[70][71][72].…”

Section: Treatment and Prognosismentioning

confidence: 99%

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Managing Paraneoplastic Neurological Disorders

2006

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Section: Opsoclonus-myoclonusmentioning

confidence: 99%

“…The most commonly associated neoplasms are SCLC and breast and gynecologic cancers [55,56]. Many other tumors, including thyroid and bladder cancer, have also been reported [57].…”

Section: Underlying Tumormentioning

confidence: 99%

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Managing Paraneoplastic Neurological Disorders

2006

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“…Anti-Yo is directed against a protein expressed by Purkinje cells, causing inflammation and cerebellar degeneration (Shams'ili et al 2003). These antibodies cause impairment of ocular motility (Escudero et al 1993;Ohmer et al 1999), nystagmus and other saccadic intrusions and oscillations (Budde-Steffen et al 1988;Wirtz et al 2002).…”

Section: Paraneoplastic Effects Of Breast Cancer On the Eyementioning

confidence: 99%

Ocular presentations of breast cancer

Wickremasinghe

Dansingani

Tranos

et al. 2006

Acta Ophthalmologica Scandinavica

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IntroductionBreast cancer is the most common malignancy in women (Office of National Statistics 2002). As ophthalmic manifestations are common, the astute ophthalmologist can instigate the search for primary disease when the first presentation is ophthalmic in nature, or, alternatively, play an important role in detecting the metastatic spread of a known primary. Breast cancer accounts for 29% of new malignancies in women in the UK and is a major cause of mortality and morbidity worldwide.The purpose of this article is to provide a review of the ophthalmic manifestations of breast cancer. The subjects covered include the presenting features of metastatic disease involving the visual systems, treatment modalities and strategies currently available, and the ocular effects and complications of treatment. EpidemiologyIncidence rates of breast cancer have increased over the last decade, rising from 90 to 130 per 100 000 population (1988 versus 1998) (Office of National Statistics 2002). In contrast, mortality rates have remained relatively stable since the 1950s. This increase in the incidence of breast cancer is attributed to more effective screening programmes, although a change in the demographics of developed countries and an increasing elderly population may contribute to the growing incidence. Geographical variations exist in breast cancer incidence rates, with higher rates in Europe, North America and Oceania and lower rates in Asia and Africa (Sasco 2001). Doctors practising in the western world should be familiar with the disease.Male breast cancer is rare. The incidence is 0.8-1.5 cases per 100 000 male population, accounting for 1% of all breast cancer diagnoses (Office of National Statistics 2002; Hodgson et al. 2004). The highest incidence occurs in men aged over 70 years (Kidmas et al. 2005). In families with hereditary breast cancer, younger males may be affected. The BRCA2 gene is often implicated in these cases (Lorenzo Bermejo & Hemminki 2005).Ocular manifestations of male breast cancer can occur and this differential diagnosis should not be overlooked (O'Brien et al. 2000;Silvestris et al. 2003;Dieing et al. 2004). Ophthalmic metastases in breast cancerMetastatic disease to the eye from the breast was first described by Johann ABSTRACT.Context: Breast cancer is the most common malignancy in women, with increasing incidence in Europe and North America. The frequency of involvement of the eye and visual pathways is reported to be as high as 30% in patients with known metastatic disease. In some cases, ophthalmic involvement can be the first sign of metastatic spread. Metastasis occurs via the haematogenous route and predominantly involves the choroid. Metastases to other ocular structures, the orbit and the visual pathways have also been described. Paraneoplastic effects are rare but significant. Treatments: Different modalities are employed in the treatment of breast cancer and its metastases. These include chemotherapy and radiotherapy. The ocular adverse effects of these have been well described,...

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“…There are, however, diverse antibodies present in adults with OMS varying with the nature of the underlying cancer. Anti-Ri antibodies are associated with breast cancer, 22 though their presence in sera from a patient with a paraneoplastic-like illness does not inevitably lead to the discovery of an occult lesion. 23 No specific antibody has been identified in children with OMS and it is probable that those identified so far are of secondary rather than of primary significance and are directed to nuclei rather than to cell-surface antigens.…”

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confidence: 99%

Neuroimmunology of dancing eye syndrome in children

Wilson¹

2007

Developmental Medicine &Amp; Child Neurology

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Clinical, histopathological, and laboratory evidence suggest that dancing eye syndrome/opsoclonus‐mycoclonus syndrome is an immune‐mediated and probably autoimmune disorder. There is a clear, but not invariable, association with neuroblastoma or ganglioneuroma in children, and with a miscellany of neoplasms in adults. Direct support, i.e. the identification of antibodies against cell‐surface antigens in neurons, is lacking but the nature of other evidence is such that the case for use of immunomodulatory therapeutic strategies is compelling. Because at least 85% of children affected by the condition are left with permanent cognitive deficits, notwithstanding a favourable initial neurological response to, say, steroid or adrenocorticotrophic hormone, therapeutic stakes are high. There is an urgent need for controlled therapeutic trials which, because of the comparative rarity of the condition in children, will require international collaboration to expedite studies.

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Anti-Ri antibody positive opsoclonus-myoclonus in a male patient with breast carcinoma

Cited by 28 publications

References 15 publications

Managing Paraneoplastic Neurological Disorders

Managing Paraneoplastic Neurological Disorders

Ocular presentations of breast cancer

Neuroimmunology of dancing eye syndrome in children

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