Catastrophic relapses following initiation of dimethyl fumarate in two patients with neuromyelitis optica spectrum disorder

We report two cases of neuromyelitis optica spectrum disorder (NMOSD) who were misdiagnosed as multiple sclerosis (MS) and developed catastrophic relapses following initiation of dimethyl fumarate. Both patients developed a severe myelitis extending from the cervical cord to the medulla with signifi...

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Bibliographic Details
Published in:Multiple sclerosis 2017-08, Vol.23 (9), p.1297-1300
Main Authors: Yamout, Bassem I, Beaini, Shawkat, Zeineddine, Maya M, Akkawi, Nabil
Format: Article
Language:English
Subjects:
Adult
Blindness - chemically induced
Diagnostic Errors
Dimethyl Fumarate - adverse effects
Fatal Outcome
Female
Humans
Immunosuppressive Agents - adverse effects
Middle Aged
Multiple Sclerosis - diagnosis
Multiple Sclerosis - drug therapy
Myelitis - chemically induced
Neuromyelitis Optica - diagnosis
Neuromyelitis Optica - drug therapy
Quadriplegia - chemically induced
Recurrence
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Description
Summary:We report two cases of neuromyelitis optica spectrum disorder (NMOSD) who were misdiagnosed as multiple sclerosis (MS) and developed catastrophic relapses following initiation of dimethyl fumarate. Both patients developed a severe myelitis extending from the cervical cord to the medulla with significant cord swelling, resulting in complete quadriplegia and respiratory difficulties, in addition to severe bilateral visual loss in one patient. It is of note that both catastrophic relapses occurred 2 and 3 months following initiation of dimethyl fumarate.
ISSN:1352-4585
1477-0970
DOI:10.1177/1352458517694086