Progressive encephalomyelitis with rigidity: a Taiwanese case and review of literature

<p><strong>Introduction</strong></p> Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a rare disorder. However, the outcome is still variable with different serological and tumor associations, and the elements to good response with less relapse is yet to be...

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التفاصيل البيبلوغرافية
المؤلفون الرئيسيون: Chang, A, Lin, K-Y, Chuang, K-J, Waters, P, Irani, SR, Mgbachi, V, Yeh, H-L, Lien, L-M, Chiu, H-C, Chen, W-H
التنسيق: Journal article
اللغة:English
منشور في: Elsevier 2021
الوصف
الملخص:<p><strong>Introduction</strong></p> Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a rare disorder. However, the outcome is still variable with different serological and tumor associations, and the elements to good response with less relapse is yet to be elucidated. <p><strong>Method</strong></p> We present a case and obtain a literature review of patients with PERM and make comparisons based on different serological groups. We also analyze patients with idiopathic PERM that had detailed medical records. <p><strong>Results</strong></p> 81 patients were collected and analyzed. The largest group were glycine receptor-antibody (GlyR-Ab)-positive (70%), and the seropositive-GlyR-Ab-negative group had better response to immunotherapy. Malignancy can occur up to 2 years from the presentation of PERM. Among the 18 cases with detailed records, the patients who had good outcome initiate immunotherapy within 2 months from presentation. 9 of the 12 patients who experienced no relapse had non-steroid immunotherapy. The maximal interval time of relapse was 24 months. <p><strong>Conclusion</strong></p> We recommend tumor surveillance up to 2 years in patients with PERM and early administration of immunotherapies and maintain with non-steroid immunotherapy with or without oral corticosteroid for a minimum of 2 years to reduce the risk of relapse in GlyR-Ab-positive patients.