Department of Neurology, Karadeniz Technical University, Trabzon, Turkey.
Department of Neurology, Ondokuz Mayis University, Samsun, Turkey.
Mult Scler. 2018 Aug;24(9):1205-1211. doi: 10.1177/1352458517717806. Epub 2017 Jun 26.
Women with multiple sclerosis (MS) experience an increased risk of relapse in the postpartum period. High-dose methylprednisolone is the first-line treatment for acute relapses.
To determine the transfer of methylprednisolone into human milk in breastfeeding MS patients.
Methylprednisolone therapy was given for postpartum relapse to nine patients for three consecutive days, and seven patients received a daily infusion once a month. Breast milk samples were obtained before infusion and 1, 2, 4, 8, and 12 hours after completion of infusion.
Methylprednisolone concentrations in milk were below detection limits immediately before infusion. C was measured at 1, 2, 4, 8, and 12 hours after infusion and levels of 2.100, 1.659, 0.680, 0.174, and 0.102 µg/mL were determined, respectively. The absolute infant dose was 98.98 µg/kg/day, and the relative infant dose (RID) was 0.71% of the weight-adjusted maternal dose.
The level of methylprednisolone transfer into breast milk is very low. The RID for methylprednisolone was lower than the generally accepted value. As methylprednisolone therapy is of short duration, infant exposure would be very low should a mother choose to breastfeed 1 hour after infusion. Waiting 2-4 hours after infusion will limit infant exposure still further.
多发性硬化症（MS）女性在产后期间复发的风险增加。大剂量甲基强的松龙是急性复发的一线治疗药物。
确定母乳喂养的多发性硬化症患者中甲基强的松龙在人乳中的转移情况。
对 9 名患者进行连续 3 天的产后复发甲基强的松龙治疗，对 7 名患者每月进行一次每日输注。在输注前和输注后 1、2、4、8 和 12 小时采集母乳样本。
输注前立即检测到母乳中甲基强的松龙浓度低于检测限。C 在输注后 1、2、4、8 和 12 小时进行测量，分别为 2.100、1.659、0.680、0.174 和 0.102µg/mL。婴儿的绝对剂量为 98.98µg/kg/天，相对婴儿剂量（RID）为体重调整后母亲剂量的 0.71%。
甲基强的松龙转移到母乳中的水平非常低。甲基强的松龙的 RID 低于公认的值。由于甲基强的松龙治疗的持续时间较短，如果母亲在输注后 1 小时选择母乳喂养，婴儿的暴露量将非常低。输注后等待 2-4 小时将进一步限制婴儿的暴露量。
