Neuromyelitis Optica in Pregnancy Complicated by Posterior Reversible Encephalopathy Syndrome, Eclampsia and Fetal Death

Catherine Igel, Diana Garretto, Matthew S Robbins, Michael Swerdlow, Nancy Judge, Ashlesha Dayal

Abstract


Neuromyelitis optica (NMO) is a demyelinating syndrome characterized by optic neuritis and acute myelitis with poor recovery and a progressive course. We report a poor outcome complicated by posterior reversible encephalopathy syndrome (PRES) and eclampsia and review available literature and current evidence for anticipation of adverse fetal and maternal effects. After a pregnancy complicated by multiple admissions for painful NMO exacerbations, a primiparous patient with seropositive NMO presented at 31 + 3/7 weeks with eclampsia, HELLP and subsequent fetal death. MRI confirmed PRES. NMO may be associated with eclampsia and leads to adverse maternal and fetal outcomes. Posited mechanisms include antibody-mediated placental damage and a heightened risk of eclampsia-associated PRES. Further characterization of the course of NMO and its relationship with pregnancy outcomes in larger series would be invaluable.




J Clin Med Res. 2015;7(3):193-195
doi: http://dx.doi.org/10.14740/jocmr2031w

Keywords


Aquaporin 4; Devic’s disease; Eclampsia; Posterior reversible encephalopathy syndrome; Neuromyelitis optica

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