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. 2018 Dec;11(4):171-177.
doi: 10.1177/1753495X18758868. Epub 2018 Apr 16.

Devic syndrome and pregnancy: A case series

Danielle Wuebbolt  1   2 , Vanessa Nguyen  1   2 , Rohan D'Souza  2 , Ahraaz Wyne  3
Affiliations

Devic syndrome and pregnancy: A case series

Danielle Wuebbolt et al. Obstet Med. 2018 Dec.

Abstract

Background: Devic syndrome or neuromyelitis optica is an autoimmune neurological condition characterized by relapsing symptoms of optic neuritis and transverse myelitis. Women with neuromyelitis optica suffer from adverse pregnancy outcomes and high relapse rates during pregnancy and the postpartum period.

Methods: This case series describes 13 pregnancies in four women with neuromyelitis optica managed at a tertiary hospital in Toronto, Canada.

Results: In most cases, neurologic symptoms either worsened or developed for the first time during pregnancy or the postpartum period, and often responded to a combination of steroids, immunosuppressant medications, plasma exchange and intravenous immunoglobulin. The 13 pregnancies resulted in two miscarriages, three preterm and eight term births. One fetus whose mother was on gabapentin, prednisone and spironolactone, had congenital malformations (aplastic lung and fused fingers).

Conclusions: Despite high frequency of relapses in pregnancy and the postpartum period, with multidisciplinary team management, outcomes for women with neuromyelitis optica are encouraging.

Keywords: Complications; autoimmune demyelinating disease; drugs (medication); high-risk pregnancy; maternal-fetal medicine.

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Figures

Figure 1.
Figure 1.
Case 1. IV: intravenous; CS: cesarean section; SVD: spontaneous vaginal delivery.
Figure 2.
Figure 2.
Case 2.
Figure 3.
Figure 3.
Case 3.
Figure 4.
Figure 4.
Case 4.
See this image and copyright information in PMC

References

    1. Wingerchuk DM, Lennon VA, Lucchinetti CF, et al. The spectrum of neuromyelitis optica. Lancet Neurol 2007; 6: 805–815. - PubMed
    1. Fragoso YD, Adoni T, Bichuetti DB, et al. Neuromyelitis optica and pregnancy. J Neurol 2013; 260: 2614–2619. - PubMed
    1. Rubio T J, Amaya G PF. Plasma exchange therapy for a severe relapse of Devic's disease in a pregnant woman: a case report and concise review. Clin Neurol Neurosurg 2016; 148: 88–90. - PubMed
    1. Igel C, Garretto D, Robbins MS, et al. Neuromyelitis optica in pregnancy complicated by posterior reversible encephalopathy syndrome, eclampsia and fetal death. J Clin Med Res 2015; 7: 193–195. - PMC - PubMed
    1. Nour MM, Nakashima I, Coutinho E, et al. Pregnancy outcomes in aquaporin-4-positive neuromyelitis optica spectrum disorder. Neurology 2016; 86: 79–87. - PMC - PubMed

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