Two cases of anaphylactic shock by methylprednisolone in neuromyelitis optica. (October 2018)

• Record Type: Journal Article
• Authors: Takahashi, Keita; Asano, Tetsuya; Higashiyama, Yuichi; Koyano, Shigeru; Doi, Hiroshi; Takeuchi, Hideyuki; Tanaka, Fumiaki
• Is Part Of: Multiple sclerosis. Volume 24:Number 11(2018)
• Page Start: 1514
• Page End: 1516
• Publication Date: 2018-10
• Subjects: Neuromyelitis optica -- anaphylactic shock -- methylprednisolone -- betamethasone -- succinate ester; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458518763099
• Languages: English
• ISSNs: 1352-4585

Abstract

Steroid pulse therapy with methylprednisolone (mPSL) succinate ester is the most common treatment for neuromyelitis optica (NMO); no cases of anaphylaxis have been reported to date. Here, we report two cases of anaphylactic shock induced by mPSL pulse therapy in patients with NMO and concurrent systemic lupus erythematosus. Both patients had received several courses of mPSL pulse therapy without any problems previously. Repeated mPSL pulse therapy and comorbid humoral autoimmune disease might increase the risk of anaphylaxis. Corticosteroids without succinate esters should be considered as an alternative therapy to prevent anaphylaxis.