Medically Refractory Multiple Sclerosis Is Successfully Treated with Plasmapheresis in a Super Morbidly Obese Pregnant Patient
Joint Authors
Dalka, Lindsey
Harb, Antoine
Mikesell, Kael
Gordon Perue, Gillian
Source
Case Reports in Neurological Medicine
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-04-04
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
Multiple sclerosis (MS) is a relapse remitting immune-mediated demyelinating neurological disorder that primarily affects women of childbearing age.
In most patients, the hormonal changes during pregnancy are protective against MS relapses.
When relapses do occur, treatment options are limited to use of intravenous steroids and plasmapheresis rescue therapy.
We present a case of steroid refractory MS-transverse myelitis with quadriplegia in a 25-year-old pregnant super morbidly obese woman.
Our clinical case is unique because the severity of her relapse early in pregnancy, which was intractable and resistant to steroids.
This may have been a rebound demyelination due to the discontinuation of fingolimod; a newly recognized entity by the FDA.
Our case report therefore seeks to raise awareness about a potential complication of discontinuing MS disease modifying therapies, highlighting that these rebound relapses can be steroid resistant and occur despite the usual protective hormonal influence of early pregnancy and that plasma exchange is a valid treatment option.
Finally, we discuss the challenges of determining exchange volumes for plasmapheresis in the super morbid obese population to secure good maternal and fetal outcomes.
American Psychological Association (APA)
Dalka, Lindsey& Harb, Antoine& Mikesell, Kael& Gordon Perue, Gillian. 2020. Medically Refractory Multiple Sclerosis Is Successfully Treated with Plasmapheresis in a Super Morbidly Obese Pregnant Patient. Case Reports in Neurological Medicine،Vol. 2020, no. 2020, pp.1-3.
https://search.emarefa.net/detail/BIM-1148898
Modern Language Association (MLA)
Dalka, Lindsey…[et al.]. Medically Refractory Multiple Sclerosis Is Successfully Treated with Plasmapheresis in a Super Morbidly Obese Pregnant Patient. Case Reports in Neurological Medicine No. 2020 (2020), pp.1-3.
https://search.emarefa.net/detail/BIM-1148898
American Medical Association (AMA)
Dalka, Lindsey& Harb, Antoine& Mikesell, Kael& Gordon Perue, Gillian. Medically Refractory Multiple Sclerosis Is Successfully Treated with Plasmapheresis in a Super Morbidly Obese Pregnant Patient. Case Reports in Neurological Medicine. 2020. Vol. 2020, no. 2020, pp.1-3.
https://search.emarefa.net/detail/BIM-1148898
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1148898