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January 1990

Plasmapheresis in a Pregnant Patient With Multiple Sclerosis

Author Affiliations

Department of Neurology Medical College of Wisconsin Milwaukee, WI 53226

Arch Neurol. 1990;47(1):11-12. doi:10.1001/archneur.1990.00530010017007

To the Editor.  —Plasmapheresis combined with immunosuppressive drug therapy is of proven benefit in both acute and chronic progressive multiple sclerosis.1,2 We present our experience with plasmapheresis alone in a pregnant patient with multiple sclerosis with high-risk obstetric profile and severely progressive multiple sclerosis.

Report of a Case.  —A 28-year-old patient with a clinically definite diagnosis of multiple sclerosis had a 2-month history of progressive neurological deterioration. She was 9 weeks pregnant, confined to a wheel-chair, and unable to stand or transfer independently; unable to feed herself because of weakness; incontinent of bowel and bladder; and experienced diplopia when tired. The previous two pregnancies had resulted in stillbirths.Immunosuppressive drug therapy for her multiple sclerosis was considered to be a relative contraindication because of its adverse effect on the fetus and also given her high-risk obstetric history. Therefore, intensive plasmapheresis (five treatments in 10 days) was begun with significant