Role of plasmapheresis in neuromyelitis optica spectrum disorders

Purpose: We report a case of Neuromyelitis optica spectrum disorder (NMOSD) which has failed to respond to the first line treatment i.e. IV methylprednisolone and had responded well to the plasmapheresis. Method: A 23-year-old female presented with complaint of sudden painless diminution of visio...

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Bibliographic Details
Main Authors: Pranathi B, Nashrah Nooreen, Madhuri Gadde, Anitha Videkar
Format: Article
Language:English
Published: KIMS Foundation and Research Center 2019-10-01
Series:Journal of Medical and Scientific Research
Subjects:
Online Access:http://jmsronline.com/article.aspx?ID=plasmapheresis-in-neuromyelitis-optica-spectrum-disorders
Description
Summary:Purpose: We report a case of Neuromyelitis optica spectrum disorder (NMOSD) which has failed to respond to the first line treatment i.e. IV methylprednisolone and had responded well to the plasmapheresis. Method: A 23-year-old female presented with complaint of sudden painless diminution of vision in both eyes which is progressive in nature associated with severe headache, with no systemic symptoms, since 10 days. On examination patient denied perception to light in both eyes. On anterior segment examination both the pupil were 6mm dilated, ill sustained and sluggishly reacting to light, rest anterior segment was normal. Fundus examination of both eyes showed hyperemic pallid disc edema with blurring of margins all around associated with tortuous vessels with foveal reflux present. We started her on IV methyl prednisolone for 3 days but did not respond, then we switched to plasmapheresis. Results: After 2nd cycles of plasmapheresis the vision improved to hand movement in both eyes and after 7thcycle the vision improved to counting fingers at 4meters. And the patient was maintained on tapering dose of steroids (50mg/day) and azathioprine 100mg/day (2-3 mg/kg/day) was started. Conclusions: Plasmapheresis is an effective therapy in NMOSD patients and should be considered if the patient fails to respond to the initial therapy.
ISSN:2321-1326
2394-112X