Plasma exchange therapy for a severe relapse of Devic's disease in a pregnant woman: A case report and concise review

Neuromyelitis optica (NMO) or Devic's disease is an autoimmune inflammatory demyelinating condition affecting the central nervous system (CNS). It was initially believed to be a variant of multiple sclerosis (MS). However, the discovery of NMO-IgG anti-AQP4 antibodies marked an objective distinction between these conditions. Treatment of acute attacks is generally based on pulsed steroids, followed by long-term immunosuppression with azathioprine, oral steroids, and rituximab as first-line therapies. Plasma exchange therapy is indicated for steroid-resistant relapses. We describe a case report of a pregnant woman with a severe relapse of Devic's disease, initially misdiagnosed as MS, unresponsive to pulsed steroids, and who underwent plasma exchange therapy safely, with excellent clinical response and with no adverse outcome for the fetus. © 2016 Elsevier B.V.

• Fecha de publicación: 2016
• Institución: Universidad del Rosario
• Repositorio: Repositorio EdocUR - U. Rosario
• Idioma: eng
• OAI Identifier: oai:repository.urosario.edu.co:10336/23689
• Acceso en línea: https://doi.org/10.1016/j.clineuro.2016.07.004; https://repository.urosario.edu.co/handle/10336/23689
• Palabra clave: Azathioprine; Immunoglobulin g; Methylprednisolone; Prednisone; Adult; Afferent pupillary defect; Antibody titer; Babinski reflex; Blindness; Case report; Cervical spinal cord; Cesarean section; Colombia; Corticosteroid therapy; Dermatome; Diagnostic error; Eclampsia; Female; Follow up; Gait disorder; Human; Hyperreflexia; Immunosuppressive treatment; Leg muscle; Medical record review; Multiple sclerosis; Muscle strength; Mydriasis; Myelooptic neuropathy; Nuclear magnetic resonance imaging; Optic neuritis; Papilledema; Paraplegia; Paresthesia; Physical examination; Plasmapheresis; Preeclampsia; Pregnant woman; Primigravida; Relapse; Review; Sensory dysfunction; Thoracic spinal cord; Treatment response; Visual acuity; White matter lesion; Neuromyelitis optica; Plasma exchange; Pregnancy; Pregnancy complications; Procedures; Adult; Female; Humans; Neuromyelitis optica; Plasma exchange; Pregnancy; Pregnancy complications; Devic's disease; Neuromyelitis optica; Plasma exchange; Pregnancy
• License: Abierto (Texto Completo)