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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| Format: | Article |
| Language: | English |
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KIMS Foundation and Research Center
2019-10-01
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| Series: | Journal of Medical and Scientific Research |
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| Online Access: | http://jmsronline.com/article.aspx?ID=plasmapheresis-in-neuromyelitis-optica-spectrum-disorders |
| _version_ | 1818541032998961152 |
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| author | Pranathi B Nashrah Nooreen Madhuri Gadde Anitha Videkar |
| author_facet | Pranathi B Nashrah Nooreen Madhuri Gadde Anitha Videkar |
| author_sort | Pranathi B |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T22:03:14Z |
| format | Article |
| id | doaj.art-48d46af856bf42c3bb02d75824e93ba4 |
| institution | Directory Open Access Journal |
| issn | 2321-1326 2394-112X |
| language | English |
| last_indexed | 2024-12-11T22:03:14Z |
| publishDate | 2019-10-01 |
| publisher | KIMS Foundation and Research Center |
| record_format | Article |
| series | Journal of Medical and Scientific Research |
| spelling | doaj.art-48d46af856bf42c3bb02d75824e93ba42022-12-22T00:49:02ZengKIMS Foundation and Research CenterJournal of Medical and Scientific Research2321-13262394-112X2019-10-017411511910.17727/JMSR.2019/7-20Role of plasmapheresis in neuromyelitis optica spectrum disordersPranathi B0Nashrah Nooreen1Madhuri Gadde2Anitha Videkar3Department of Ophthalmology, Krishna Institute of Medical Sciences (KIMS), Secunderabad-500003, Telangana, India Department of Ophthalmology, Krishna Institute of Medical Sciences (KIMS), Secunderabad-500003, Telangana, India Department of Ophthalmology, Krishna Institute of Medical Sciences (KIMS), Secunderabad-500003, Telangana, India Department of Ophthalmology, Krishna Institute of Medical Sciences (KIMS), Secunderabad-500003, Telangana, India 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.http://jmsronline.com/article.aspx?ID=plasmapheresis-in-neuromyelitis-optica-spectrum-disordersneuromyelitis opticapainless progressive diminision of visionsluggishly reacting pupilhyperemic pallid discmethylprednisoloneplasmapheresis |
| spellingShingle | Pranathi B Nashrah Nooreen Madhuri Gadde Anitha Videkar Role of plasmapheresis in neuromyelitis optica spectrum disorders Journal of Medical and Scientific Research neuromyelitis optica painless progressive diminision of vision sluggishly reacting pupil hyperemic pallid disc methylprednisolone plasmapheresis |
| title | Role of plasmapheresis in neuromyelitis optica spectrum disorders |
| title_full | Role of plasmapheresis in neuromyelitis optica spectrum disorders |
| title_fullStr | Role of plasmapheresis in neuromyelitis optica spectrum disorders |
| title_full_unstemmed | Role of plasmapheresis in neuromyelitis optica spectrum disorders |
| title_short | Role of plasmapheresis in neuromyelitis optica spectrum disorders |
| title_sort | role of plasmapheresis in neuromyelitis optica spectrum disorders |
| topic | neuromyelitis optica painless progressive diminision of vision sluggishly reacting pupil hyperemic pallid disc methylprednisolone plasmapheresis |
| url | http://jmsronline.com/article.aspx?ID=plasmapheresis-in-neuromyelitis-optica-spectrum-disorders |
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