利妥昔单抗治疗视神经脊髓炎谱系障碍患者的妊娠结局：一项病例系列研究。
Pregnancy outcome in patients with neuromyelitis optica spectrum disorder treated with rituximab: A case-series study.
作者信息
Seyed Ahadi Maral, Sahraian Mohammad Ali, Shaygannejad Vahid, Anjidani Nassim, Mohammadiani Nejad Seyed Ehsan, Beladi Moghadam Nahid, Ayromlou Hormoz, Yousefi Pour Gholam Ali, Yazdanbakhsh Sepideh, Jafari Mehrdad, Naser Moghadasi Abdorreza
机构信息
Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
Caspian J Intern Med. 2021;12(Suppl 2):S491-S494. doi: 10.22088/cjim.12.0.491.
BACKGROUND
Neuromyelitis optica spectrum disorder (NMOSD) is a neuroinflammatory disorder with a tendency to affect the spinal cord and optic nerves. As NMOSDs have a predilection for women of reproductive age and adopt an aggressive course during pregnancy, appropriate treatment strategies before conception and during pregnancy should be well-considered.
CASE PRESENTATION
In this report, the pregnancy outcome of eight pregnancies following rituximab treatment was assessed, which led to 50% live births with mean birth weight of 2777.50 (SD: 545.92) grams. Two patients had abortions due to doctor's recommendation. One pregnancy led to intrauterine fetal death (IUFD) due to nuchal cord. No spontaneous abortions were encountered. Two patients received rituximab during pregnancy. No major malformations or serious neonatal infections were encountered.
CONCLUSION
Rituximab should be administered by caution in NMOSD patients who want to be pregnant and the probable adverse effects of the drug should be discussed by patients.
背景
视神经脊髓炎谱系障碍（NMOSD）是一种具有影响脊髓和视神经倾向的神经炎症性疾病。由于NMOSD好发于育龄女性且在孕期病情进展迅速，因此在受孕前和孕期应充分考虑合适的治疗策略。
病例报告
本报告评估了8例接受利妥昔单抗治疗后的妊娠结局，其中50%为活产，平均出生体重为2777.50（标准差：545.92）克。2例患者因医生建议而流产。1例妊娠因脐带绕颈导致宫内胎儿死亡（IUFD）。未发生自然流产。2例患者在孕期接受了利妥昔单抗治疗。未出现重大畸形或严重的新生儿感染。
结论
对于有妊娠意愿的NMOSD患者，使用利妥昔单抗时应谨慎，且应与患者讨论该药物可能的不良反应。
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