Highlights
- •Gonadotropin-treatment is considered a safer option for MS-patients than GnRH agonists.
- •We present a patient with a nearly fulminant relapse after starting gonadotropin-treatment.
- •The case demonstrates a safety concern regarding gonadotropin-treatment in MS-patients.
Abstract
Several reports indicate increased disease activity in patients with multiple sclerosis
(MS) undergoing assisted reproductive techniques (ART), in the form of gonadtopin
releasing hormone (GnRH) agonists. Other forms of ART treatments, like gonadotropin-treatment,
have therefore been considered a safer option for MS-patients. We present a patient
who despite being completely clinically and radiologically stable for eight years
during disease modifying therapy experienced a nearly fulminant disease course almost
immediately after starting gonadotropin-treatment, indicating that this form of follicle
stimulating treatment could also be a major risk factor for MS disease activity.
Keywords
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References
- Increase in multiple sclerosis activity after assisted reproduction technology.Ann. Neurol. 2012; 72 (Epub 2012 Oct 3): 682-694https://doi.org/10.1002/ana.23745
- Reconstitution of the peripheral immune repertoire following withdrawal of fingolimod.Mult. Scler. 2017; 23: 1225-1232
- Rebound syndrome in patients with multiple sclerosis after cessation of fingolimod treatment.JAMA Neurol. 2016; 73 (Jul 1): 790-794
- Artificial reproductive techniques in multiple sclerosis.Clin. Immunol. 2013; 149: 219-224
- A comparison of multiple sclerosis disease activity after discontinuation of fingolimod and placebo.Mult. Scler. J. Exp. Transl. Clin. 2017; 3 (eCollection 2017)(2055217317730096)https://doi.org/10.1177/2055217317730096
- Multiple sclerosis and pregnancy in the 'treatment era'.Nat. Rev. Neurol. 2015; 11: 280-289https://doi.org/10.1038/nrneurol.2015.53
Article info
Publication history
Published online: February 28, 2018
Accepted:
February 27,
2018
Received in revised form:
February 20,
2018
Received:
January 26,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
