Pregnancy management in NMO: A case of MOG- Antibody Positiv
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Neuromyelitis optica (NMO) is a rare but severely disabling disease, affecting predominantly the optic nerves and spinal cord. Aquaporin-4 (AQP4 IgG) antibodies have been described as characteristic and pathogenic for the disease. Some NMO cases are AQP4 IgG negative, of which a fraction has antibodies against myelin oligodendrocyte glycoprotein (MOG). We report the pregnancy of a 42-year-old English woman who was diagnosed with neuromyelitis optica spectrum disorder (NMOSD), with anti-MOG antibodies. She fell pregnant prior to starting immunosuppressive therapy. At week 30 of gestation, she experienced a relapse and was treated with high dose steroids. She developed further right-hand numbness in the week post-partum and had MRI confirmation of a new cervical lesion. This case suggests that unlike in multiple sclerosis (MS), pregnancy does not protect from relapses in NMO.

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