scholarly journals Clinical Responses to Rituximab in a Case of Neuroblastoma with Refractory Opsoclonus Myoclonus Ataxia Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Samin Alavi ◽  
Ali Kord Valeshabad ◽  
Borhan Moradveisi ◽  
Ali Aminasnafi ◽  
Mohammad Taghi Arzanian
Keyword(s):  
Eye Movements ◽  
Intravenous Immunoglobulin ◽  
Severity Score ◽  
Adrenocorticotropic Hormone ◽  
Efficacy And Safety ◽  
Imaging Studies ◽  
Immune Mediated ◽  
Clinical Responses ◽  
Ataxia Syndrome ◽  
Refractory Case

Opsoclonus myoclonus ataxia syndrome (OMS) is a rare neurologic syndrome. In a high proportion of children, it is associated with neuroblastoma. The etiology of this condition is thought to be immune mediated. In children, immunotherapy with conventional treatments such as corticosteroids, intravenous immunoglobulin, adrenocorticotropic hormone, and even antiepileptic drugs has been tried. Recently rituximab has been used safely for refractory OMS in children with neuroblastoma. Our patient was a 3.5-year-old girl referred for ataxia and dancing eye movements starting since 1.5 years ago. She was diagnosed with neuroblastoma on imaging studies on admission. The OMS was refractory to surgical resection, chemotherapy, corticosteroids, and intravenous immunoglobulin. Patient received rituximab simultaneously with chemotherapy. The total severity score decreased by 61.1% after rituximab. Patient's ataxia markedly improved that she was able to walk independently after 6 months. Our case confirmed the clinical efficacy and safety of rituximab in a refractory case of OMS.

scholarly journals Efficacy and safety associated with the infusion speed of intravenous immunoglobulin for the treatment of Kawasaki disease: a randomized controlled trial

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Saori Fukui ◽  
Mitsuru Seki ◽  
Takaomi Minami ◽  
Kazuhiko Kotani ◽  
Kensuke Oka ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Adverse Events ◽  
Intravenous Immunoglobulin ◽  
Controlled Study ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Link Type ◽  
Cell Counts ◽  
Infusion Speed ◽  
Ivig Administration

Abstract Background High-dose intravenous immunoglobulin (IVIG) is the mainstay of treatment for Kawasaki disease (KD). Usually, 2 g/kg of IVIG is administered over 10–24 h, depending on the institution or physician, but the association between infusion speed and effectiveness has not been reported. In this study, we evaluated the differences in efficacy and safety between two different IVIG administration speeds. Methods This was a multicenter, unblinded, randomized controlled study. Patients newly diagnosed with KD were randomized into two groups: one who received IVIG over 12 h (12H group, double speed), and one that received IVIG over 24 h (24H group, reference speed). The endpoints included the duration of fever, incidence of coronary artery abnormalities (CAAs) and of adverse events. Laboratory data were evaluated before and after IVIG administration. Results A total of 39 patients were enrolled. There was no difference between groups in fever duration after the initiation of IVIG (21 h vs. 21.5 h, p = 0.325), and no patient experienced CAAs. Two adverse events were observed in the 12H group (elevation of aspartate aminotransferase and vomiting), however no severe adverse events requiring treatments or extension of hospital stay were observed in either group. After initial IVIG administration, the change ratio of inflammatory markers, such as white blood cell counts, neutrophils, C-reactive protein, and albumin, did not show significant differences between the two groups. On the other hand, a greater increase of serum immunoglobulin G from its baseline level was observed in the 24H group compared to the 12H group (3037 ± 648 mg/dl vs. 2414 ± 248 mg/dl, p < 0.01). Conclusion The efficacy and safety of IVIG administered over 12 h (double speed) were similar to those administered over 24 h (reference speed). Trial registration University Hospital Medical Information Network (UMIN000014665). Registered 27 July 2014 – Prospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000017058

scholarly journals Neural Basis of Visually Guided Head Movements Studied With fMRI

2003 ◽  
Vol 89 (5) ◽  
pp. 2516-2527 ◽  
Author(s):  
Laurent Petit ◽  
Michael S. Beauchamp
Keyword(s):  
Eye Movements ◽  
Head Movement ◽  
Brain Activity ◽  
Posterior Part ◽  
Vestibular Stimulation ◽  
Head Movements ◽  
Oculomotor Control ◽  
Imaging Studies ◽  
Neural Basis ◽  
Temporoparietal Junction

We used event-related fMRI to measure brain activity while subjects performed saccadic eye, head, and gaze movements to visually presented targets. Two distinct patterns of response were observed. One set of areas was equally active during eye, head, and gaze movements and consisted of the superior and inferior subdivisions of the frontal eye fields, the supplementary eye field, the intraparietal sulcus, the precuneus, area MT in the lateral occipital sulcus and subcortically in basal ganglia, thalamus, and the superior colliculus. These areas have been previously observed in functional imaging studies of human eye movements, suggesting that a common set of brain areas subserves both oculomotor and head movement control in humans, consistent with data from single-unit recording and microstimulation studies in nonhuman primates that have described overlapping eye- and head-movement representations in oculomotor control areas. A second set of areas was active during head and gaze movements but not during eye movements. This set of areas included the posterior part of the planum temporale and the cortex at the temporoparietal junction, known as the parieto-insular vestibular cortex (PIVC). Activity in PIVC has been observed during imaging studies of invasive vestibular stimulation, and we confirm its role in processing the vestibular cues accompanying natural head movements. Our findings demonstrate that fMRI can be used to study the neural basis of head movements and show that areas that control eye movements also control head movements. In addition, we provide the first evidence for brain activity associated with vestibular input produced by natural head movements as opposed to invasive caloric or galvanic vestibular stimulation.

23 EFFICACY AND SAFETY OF VEDOLIZUMAB AND INFLIXIMAB TREATMENT FOR IMMUNE-MEDIATED DIARRHEA AND COLITIS IN CANCER PATIENTS: A MULTI-CENTER STUDY

2021 ◽  
Vol 160 (6) ◽  
pp. S-4-S-5
Author(s):  
Fangwen Zou ◽  
David M. Faleck ◽  
Anusha Shirwaikar Thomas ◽  
Jessica P. Harris ◽  
Deepika Satish ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Infliximab Treatment ◽  
Efficacy And Safety ◽  
Immune Mediated ◽  
Multi Center Study ◽  
Center Study

Successful treatment of infliximab-associated immune-mediated sensory polyradiculopathy with intravenous immunoglobulin

2013 ◽  
Vol 20 (11) ◽  
pp. 1618-1619 ◽  
Author(s):  
Hiroya Naruse ◽  
Yu Nagashima ◽  
Risa Maekawa ◽  
Takafumi Etoh ◽  
Ayumi Hida ◽  
...  
Keyword(s):  
Intravenous Immunoglobulin ◽  
Successful Treatment ◽  
Immune Mediated

scholarly journals Pembrolizumab-Induced Hypophysitis With Isolated Adrenocorticotropic Hormone (ACTH) Deficiency: A Rare Immune-Mediated Adverse Event

Cureus ◽  
2021 ◽  
Author(s):  
Andrew V Doodnauth ◽  
Miriam Klar ◽  
Yohannes S Mulatu ◽  
Zohra R Malik ◽  
Krunal H Patel ◽  
...  
Keyword(s):  
Adverse Event ◽  
Adrenocorticotropic Hormone ◽  
Acth Deficiency ◽  
Immune Mediated

Cushing Syndrome

2019 ◽  
Author(s):  
Lynnette Nieman
Keyword(s):  
Chronic Exposure ◽  
Laboratory Tests ◽  
Adrenocorticotropic Hormone ◽  
Cushing Syndrome ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Screening Tests ◽  
Imaging Studies ◽  
Common Cause ◽  
Pituitary Adrenal Axis

Cushing syndrome is a condition with protean manifestations that are caused by chronic exposure to excess glucocorticoids. Treatment with supraphysiologic doses of glucocorticoids is the most common cause. Pathologic hypercortisolism may result from autonomous adrenal production or as a result of the action of excessive adrenocorticotropic hormone (ACTH) production by a tumor, which stimulates adrenal cortisol production. Primary adrenal forms include unilateral adenoma or carcinoma or, rarely, bilateral hyperplasia and/or nodules. This chapter covers the epidemiology, etiology, pathophysiology, and diagnosis of Cushing syndrome. Clinical manifestations, physical examination findings, and laboratory tests, including tests of the blood and other body fluids, imaging studies, and biopsy, are discussed. The differential diagnosis, treatment options, complications, and prognosis are described. Tables outline clinical features and causes of Cushing syndrome, abnormalities associated with primary adrenal causes of Cushing syndrome, diagnostic accuracy of screening tests, endogenous hypercortisolism without Cushing syndrome, and medical therapy for Cushing syndrome. Figures illustrate the causes of Cushing syndrome and a comparison of the hypothalamic-pituitary-adrenal axis in patients with ACTH-dependent Cushing syndrome and those with pseudo–Cushing syndrome. Algorithms show the evaluation of possible Cushing syndrome and evaluation of the causes of Cushing syndrome. Second-line treatments for Cushing syndrome when surgery fails or is not possible are also detailed. This chapter contains 5 figures, 7 tables, 50 references.

Mechanisms of Action of Intravenous Immunoglobulin (IVIg) in Immune-Mediated Diseases

1999 ◽  
pp. 383-394
Author(s):  
K. A. Nagendra Prasad ◽  
Michel D. Kazatchkine ◽  
Srinivas V. Kaveri
Keyword(s):  
Intravenous Immunoglobulin ◽  
Mechanisms Of Action ◽  
Immune Mediated
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