Multifokální metafyzární osteonekróza kolene v důsledku pulzní léčby steroidy po ukončení léčby fingolimodem u pacientky v 19. týdnu těhotenství


Autoři: Ayfer Ertekin
Působiště autorů: Department of Neurology, Private Siirt, Hayat Hospital, Siirt, Turkey
Vyšlo v časopise: Cesk Slov Neurol N 2021; 84/117(3): 280-281
Kategorie: Dopis redakci
doi: 10.48095/cccsnn2021280

Souhrn

In MS, discontinuation of some therapies may result in increased disease activity. Fingolimod is one such agent, and severe attacks that may advance the expanded disability status scale (EDSS) may occur after the cessation of Fingolimod. Such effects may not respond to classical pulse steroid treatment [1]. High-dose pulse steroid treatments may cause osteonecrosis.

We hereby present a case of multifocal, metaphyseal osteonecrosis of the knee due to pulse steroid treatment after cessation of fingolimod treatment, which had developed in a patient who was 19 weeks pregnant.

Klíčová slova:

Pregnancy – fingolimod – osteonecrosis – pulse steroid.


Zdroje

1.Hatcher SE, Waubant E, Nourbakhsh B, et al. Rebound syndrome in patients with multiple sclerosis after cessation of fingolimod treatment. JAMA neurology 2016; 73(7): 790-794.

2.Aglietti P, Insall J, Buzzi R, et al. Idiopathic osteonecrosis of the knee. Aetiology, prognosis and treatment. The Journal of bone and joint surgery British volume 1983; 65(5): 588-597.

3.G.Novi, A. Ghezzi, M. Pizzorno, et al. Dramatic rebounds of MS during pregnancy following fingolimod withdrawal. Neurol Neuroimmunol Neuroinflamm.2018 May;5(3): e462.

4.Bove, Riley MD, MMSc; Alwan, Sura PhD; Friedman,et al.Management of Multiple Sclerosis  During  Pregnancy and the Reproductive  Years  A  Systematic  Review. Bove at al.on behalf of the Centre of Excellence in Reproduction and Child Health (MS-CERCH). Obstetrics&gynecology.2014 Dec;124(6):1157-1168.

5. Cree BA. Update on reproductive safety of current and emerging disease-modifying therapies for multiple sclerosis. Mult Scler J 2013; 19: 835–843.

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7.B.Canibaño et al. Severe rebound disease activity afterfingolimod withdrawal in apregnant woman with multiple sclerosis managed with rituximab: A case study . Case Reports in Women's Health 2020Jan; 25: doi: 10.1016/j.crwh.2019.e00162.  

8. Patricia K Coyle. Multiple sclerosis and pregnancy prescriptions.Expert Opin. Drug Saf. Expert Opin. Drug Saf. (2014) 13(12):1565-1568.

9. Diana Ramašauskaite,  Dalia Laužikiene and Audrone Arlauskien. Pregnancy and Multiple Sclerosis: An Update on the Disease Modifying Treatment Strategy and a Review of Pregnancy’s Impact on Disease Activity Medicina (Kaunas).2020 Jan 21;56(2):49.

10. Lindsey Dalka,  Antoine Harb, Kael Mikesell,  and Gillian Gordon Perue. Medically Refractory Multiple Sclerosis Is Successfully Treated with Plasmapheresis in a Super Morbidly Obese Pregnant Patient Case Rep Neurol Med.2020 Nisan 4; 2020: 4536145.

11.Weinstein RS. Glucocorticoid-induced osteoporosis and osteonecrosis. Endocrinology and metabolism clinics of North America 2012; 41(3): 595.

Štítky
Dětská neurologie Neurochirurgie Neurologie

Článek vyšel v časopise

Česká a slovenská neurologie a neurochirurgie

Číslo 3

2021 Číslo 3

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