scholarly journals Case Report: Anti-MOG Antibody Seroconversion Accompanied by Dimethyl Fumarate Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Keita Takahashi ◽  
Hideyuki Takeuchi ◽  
Ryoko Fukai ◽  
Haruko Nakamura ◽  
Keisuke Morihara ◽  
...  
Keyword(s):  
Dimethyl Fumarate ◽  
Pulse Therapy ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Peripheral Lymphocyte ◽  
Immune Disease ◽  
Autoantibody Production ◽  
Steroid Pulse ◽  
Humoral Immune ◽  
Mog Antibodies ◽  
Immune Imbalance

Here we report three cases of anti-myelin oligodendrocyte glycoprotein (MOG) antibody–associated disease (MOGAD) mimicking multiple sclerosis in which seropositivity for anti-MOG antibodies occurred during disease-modifying drug dimethyl fumarate (DMF) treatment. These patients developed relapses with anti-MOG antibody seroconversion after switching from fingolimod or steroid pulse therapy to DMF, which was associated with peripheral lymphocyte recovery. MOGAD is considered a humoral immune disease, and DMF reportedly enhances Th2-skewed humoral immune activity. Therefore, we suggest that DMF, but not fingolimod, may exacerbate humoral immune imbalance and enhance autoantibody production, leading to aggravation of MOGAD.

scholarly journals Eosinophilic Granulomatosis with Polyangiitis Presenting with Myocarditis as an Initial Symptom: A Case Report and Review of the Literature

2021 ◽  
pp. 329-333
Author(s):  
Kanako Kurihara ◽  
Jun Tsugawa ◽  
Shinji Ouma ◽  
Toshiyasu Ogata ◽  
Mikiko Aoki ◽  
...  
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Nerve Biopsy ◽  
Pulse Therapy ◽  
Sural Nerve Biopsy ◽  
Lower Limbs ◽  
Rapid Progression ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Initial Symptom ◽  
Steroid Pulse ◽  
Eosinophilic Granulomatosis

A 66-year-old woman with a history of bronchial asthma had shortness of breath and fatigue upon mild exercise. She was diagnosed as congestive heart failure. A blood test showed eosinophilia without the presence of anti-neutrophil cytoplasmic antibody (ANCA), and a myocardial biopsy specimen revealed eosinophilic infiltration in the myocardium. Eosinophilia was improved when she was administered short-term methylprednisolone. After that, she had numbness and pain in her lower limbs with re-elevation of eosinophils. She had dysesthesia and hypalgesia in the distal part of the limbs. Sural nerve biopsy revealed axonal degeneration and thickness of the arterial wall, indicating a diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA). Two courses of steroid pulse therapy were performed, resulting in marked improvement of her sensory symptoms. ANCA-negative EGPA might be associated with myocarditis and peripheral neuropathy. A sufficient immunotherapy should have been considered to prevent rapid progression.

scholarly journals A Kidney Transplant Recipient with Recurrent Henoch-Schönlein Purpura Nephritis Successfully Treated with Steroid Pulse Therapy and Epipharyngeal Abrasive Therapy

Nephron ◽  
2020 ◽  
pp. 1-5
Author(s):  
Mika Fujimoto ◽  
Kan Katayama ◽  
Kouhei Nishikawa ◽  
Shoko Mizoguchi ◽  
Keiko Oda ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Pulse Therapy ◽  
Steroid Pulse Therapy ◽  
Steroid Pulse ◽  
Schonlein Purpura ◽  
Purpura Nephritis

There is no specific treatment for recurrent Henoch-Schönlein purpura nephritis (HSPN) in a transplanted kidney. We herein report a case of a kidney transplant recipient with recurrent HSPN that was successfully treated with steroid pulse therapy and epipharyngeal abrasive therapy (EAT). A 39-year-old Japanese man developed HSPN 4 years ago and had to start hemodialysis after 2 months despite receiving steroid pulse therapy followed by oral prednisolone, plasma exchange therapy, and cyclophosphamide pulse therapy. He had undergone tonsillectomy 3 years earlier in the hopes of achieving a better outcome of a planned kidney transplantation and received a living-donor kidney transplantation from his mother 1 year earlier. Although there were no abnormalities in the renal function or urinalysis 2 months after transplantation, a routine kidney allograft biopsy revealed evidence of mesangial proliferation and cellular crescent formation. Mesangial deposition for IgA and C3 was noted, and he was diagnosed with recurrent HSPN histologically. Since the renal function and urinalysis findings deteriorated 5 months after transplantation, 2 courses of steroid pulse therapy were performed but were ineffective. EAT using 0.5% zinc chloride solution once per day was combined with the third course of steroid pulse therapy, as there were signs of chronic epipharyngitis. His renal function recovered 3 months after daily EAT and has been stable for 1.5 years since transplantation. Daily EAT continued for >3 months might be a suitable strategy for treating recurrent HSPN in cases of kidney transplantation.

Steroid pulse therapy for Kawasaki disease complicated with myocarditis

2016 ◽  
Vol 53 (11) ◽  
pp. 1015-1016 ◽  
Author(s):  
Tomomi Sato ◽  
Junpei Somura ◽  
Yoshihiro Maruo
Keyword(s):  
Kawasaki Disease ◽  
Pulse Therapy ◽  
Steroid Pulse Therapy ◽  
Steroid Pulse

Absence of Mesangial C1q Deposition Is Associated with Resolution of Proteinuria and Hematuria after Tonsillectomy Plus Steroid Pulse Therapy for Immunoglobulin A Nephropathy

Nephron ◽  
2015 ◽  
Vol 130 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Hiroki Nishiwaki ◽  
Takeshi Hasegawa ◽  
Yoshikuni Nagayama ◽  
Nobuharu Kaneshima ◽  
Mamiko Takayasu ◽  
...  
Keyword(s):  
Immunoglobulin A ◽  
Pulse Therapy ◽  
Steroid Pulse Therapy ◽  
Immunoglobulin A Nephropathy ◽  
Steroid Pulse

Pregnancy in Patients With AQP4-Ab, MOG-Ab, or Double-Negative Neuromyelitis Optica Disorder

Neurology ◽  
2021 ◽  
Vol 96 (15) ◽  
pp. e2006-e2015
Author(s):  
Nicolas Collongues ◽  
Cecilia Alves Do Rego ◽  
Bertrand Bourre ◽  
Damien Biotti ◽  
Romain Marignier ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Previous History ◽  
International Study ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Double Negative ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Pregnancy And Postpartum ◽  
History Of ◽  
Mog Antibodies ◽  
The Mean

ObjectiveTo analyze the effects of pregnancy on neuromyelitis optica spectrum disorder (NMOSD) according to patients' serostatus and immunosuppressive therapy (IST).MethodsWe performed a retrospective multicenter international study on patients with NMOSD. Patients were tested for aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies (Ab). Informative pregnancies were reported when NMOSD onset occurred before or during pregnancy or up to 12 months postpartum. The mean annualized relapse rate (ARR) was calculated for the 12 months before conception, for each trimester of pregnancy, and postpartum. Events such as miscarriage, abortion, and preeclampsia were reported. IST was considered if taken in the 3 months before or during pregnancy.ResultsWe included 89 pregnancies (46 with AQP4-Ab, 30 with MOG-Ab, and 13 without either Ab) in 58 patients with NMOSD. Compared to the prepregnancy period, the ARR was lower during pregnancy in each serostatus group and higher during the postpartum period in patients with AQP4-Ab (p < 0.01). Forty-eight percent (n = 31) of pregnancies occurred during IST and these patients presented fewer relapses during pregnancy and the 12 months postpartum than untreated patients (26% vs 53%, p = 0.04). Miscarriages occurred in 10 (11%) pregnancies, and were mainly in patients with AQP4-Ab (with or without IST) and a previous history of miscarriage. Preeclampsia was reported in 2 (2%) patients who were AQP4-Ab-positive.ConclusionWe found a rebound in the ARR during the first postpartum trimester that was higher than the prepregnancy period only in AQP4-Ab-positive patients. Taking IST just before or during pregnancy reduces the risk of relapses in these conditions.

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