Melanoma-Associated Retinopathy Treated with Ipilimumab Therapy

Abstract

Melanoma-associated retinopathy (MAR) is a rare autoimmune syndrome in patients with melanoma characterized by visual disorders. MAR is induced by the degeneration of bipolar cells of the retina and the presence of serum autoantibodies against retina proteins. Ipilimumab, an anti-cytotoxic T lymphocyte-associated antigen 4 antibody, improves survival in previously treated patients with metastatic melanoma, but is responsible for a spectrum of immune-related adverse events. Administration of ipilimumab to patients with autoimmune diseases (such as MAR or vitiligo) is actually not recommended. We report a patient presenting with MAR occurring during a melanoma relapse. Surgery and chemotherapy had no effect on visual acuity and melanoma increased. In the absence of alternative antitumoral treatment, we focused on the vital prognosis and treated the patient with ipilimumab. Two years after the treatment the patient is free from new metastasis but has presented with exacerbation of vitiligo and MAR. In the very rare case of melanoma with autoimmune disease without a therapy option, ipilimumab could be discussed, taking into account the fact that it can be effective on tumor burden but can also increase autoimmunity.

Journal

Journal ID (publisher-id): DRM

Journal ID (nlm-ta): Dermatology

Journal ID (doi): 10.1159/issn.1018-8665

Title: Dermatology

Publisher: S. Karger AG

ISSN (Print): 1018-8665

ISSN (Electronic): 1421-9832

Publication date Subscription-year: 2013

Publication date (Print): November 2013

Publication date (Electronic): 14 September 2013

Volume: 227

Issue: 2

Pages: 146-149

Affiliations

Departments of ^aInternal Medicine, ^bDermatology, ^cOphthalmology and ^dPathology, Caen University Hospital, Faculty of Medicine, University of Caen, Caen, ^eClinique Ophthalmologique, Hôpital du Val de Grâce, Paris, ^fDepartment of Cancero-Dermatology, Nantes University Hospital, Hôtel Dieu, Nantes, and ^gClinique Saint Jean, Saint-Lô, France

Author notes

*A. Audemard, Department of Internal Medicine, CHU Côte de Nacre, BP 95182, FR-14033 Caen Cedex 9 (France), E-Mail [e-mail]

Article

Publisher ID: 353408 Other ID: Dermatology 2013;227:146-149

DOI: 10.1159/000353408

PubMed ID: 24051549

Copyright statement: © 2013 S. Karger AG, Basel

License:

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Page count

Figures: 2, Pages: 4

Product

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Categories

Subject: Case Report