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シミズ ユウコ
Shimizu Yuuko
清水 優子 所属 医学部 医学科（東京女子医科大学病院） 職種 教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Pregnancy-related relapse risk factors in women with anti-AQP4 antibody positivity and neuromyelitis optica spectrum disorder. |
| 掲載誌名 | 正式名：Multiple sclerosis (Houndmills, Basingstoke, England) 略 称：Mult Scler ISSNコード：14770970/13524585 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 22(11),pp.1413-1420 |
| 著者・共著者 | Shimizu Yuko†*, Fujihara Kazuo, Ohashi Takashi, Nakashima Ichiro, Yokoyama Kazumasa, Ikeguch Ryotaro, Takahashi Toshiyuki, Misu Tatsuro, Shimizu Satoru, Aoki Masashi, Kitagawa Kazuo |
| 担当区分 | 筆頭著者,責任著者 |
| 発行年月 | 2016/10 |
| 概要 | BACKGROUND:Few reports describe the influence pregnancy has on the annualized relapse rate (ARR) in neuromyelitis optica spectrum disorder (NMOSD).OBJECTIVE:To examine pregnancy-related attacks (attacks during pregnancy or within 1 year postpartum) and identify the risk factors for an attack in Japanese NMOSD patients.METHODS:We retrospectively reviewed 139 Japanese women whom had aquaporin-4 (AQP4) antibody-positive NMOSD. Among the 114 patients with information, 47 women had 56 pregnancies. We compared the ARR before, during and after pregnancy.RESULTS:Of the 47 NMOSD patients with pregnancy, 22 women (46.8%) had a pregnancy-related attack of the disease (either an onset event or a relapse). The ARR was significantly higher in the first 3 months postpartum (1.80 ± 2.04), than before the pregnancy (0.57 ± 1.16; p = 0.0043) and did not significantly decrease during pregnancy. The ARR before hospitalization and treatment was analyzable in 55 patients without pregnancy and was 1.09 ± 1.17. Among the 11 patients with onset before pregnancy, nine patients had a pregnancy-related attack with a relapse in the previous year, and their immunosuppression was discontinued or made to be at low doses; while the two patients on higher-dose therapies were relapse-free.CONCLUSION:In the present study, pregnancy-related attack was common in NMOSD, and unlike in multiple sclerosis, the ARR was not reduced during pregnancy. Discontinued or insufficient immunosuppression appeared to increase the risk of pregnancy-related attack. |
| DOI | 10.1177/1352458515583376 |
| PMID | 25921053 |