The follow-up of acute disseminated encephalomyelitis in a comatose pregnant woman

Gaudry, P.; Lantheaume, Sophie; Renard, Jean-Luc; Koulmann, P; Ponties, J.-E.

doi:10.1016/j.ejogrb.2005.06.031

Cited by 5 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At present, it is believed that the pathogenesis of ADEM is related to the enhancement of humoral immunity, which is mediated by the increase in Th2 cytokines ( 4 , 5 , 9 – 11 , 23 , 25 , 44 ). We measured the local cytokines in the placenta and fetal membrane from the patient with pregnancy-related ADEM and the healthy control after the abortion, and found decreased level of Th1/Th2 cytokine ratio in the placenta from ADEM patient compared with those in the control.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship Between Pregnancy and Acute Disseminated Encephalomyelitis: A Single-Case Study

Deng

Qiu

et al. 2021

Front. Immunol.

View full text Add to dashboard Cite

The relationship between pregnancy and autoimmune diseases is unclear. This study investigated the possible role of local immune changes and the activation state of the HMGB1/TLR4/Nf-κB/IL-6 pathway at the maternal–fetal interface during pregnancy in the pathogenesis of acute disseminated encephalomyelitis (ADEM). Clinical data and blood samples of a patient with ADEM were collected to observe the dynamic changes in lymphocyte populations after an abortion. The expression of HMGB1, TLR4, Nf-κB, AQP4, IL-2, IL-4, IL-6, and TNF-α in the fetal membrane and placenta was compared between the patient with pregnancy-related ADEM and a woman with a normal pregnancy using Real-time qPCR and western blotting (WB). The patient was diagnosed with ADEM in the early stage of pregnancy after showing limb weakness symptoms. In the third month of gestation, the symptoms worsened, with a disturbance of consciousness and breathing. After the abortion, the patient relapsed with vertigo and visual rotation. Analysis of lymphocyte subsets by flow cytometry showed that B lymphocytes increased, while natural killer T lymphocytes decreased. WB and Real-time qPCR showed that the expression levels of HMGB1, TLR4, Nf-κB, AQP4, and IL-6 in the fetal membrane and placenta were higher in the patient with pregnancy-related ADEM than in the woman with a normal pregnancy, while those of IL-2 were lower in the patient than in the woman with a normal pregnancy. The local immune changes and the activation of the HMGB1/TLR4/Nf-κB/IL-6 pathway at the maternal–fetal interface may be related to the pathogenesis of ADEM.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Only a few cases of pregnancy-associated ADEM have been reported, and the underlying mechanism is still unclear (8)(9)(10)(11). Under healthy immune conditions, Th1 and Th2 cytokines are in a state of dynamic balance, thus maintaining normal cellular and humoral immune responses (12,13).…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Pregnancy and Acute Disseminated Encephalomyelitis: A Single-Case Study

Deng

Qiu

et al. 2021

Front. Immunol.

View full text Add to dashboard Cite

show abstract

“…The relationship between ADEM and pregnancy is uncertain. 14,15 One case of ADEM in the third trimester responded favorably to plasmapheresis after treatment failure with high-dose corticosteroids. 14 In contrast, other cases of fulminant demyelinating disease during pregnancy have resulted in coma.…”

Section: Discussionmentioning

confidence: 99%

“…14 In contrast, other cases of fulminant demyelinating disease during pregnancy have resulted in coma. 15,16 Another demyelinating illness, Marburg's Disease, is similarly rapid and fulminant, but less likely during pregnancy; 1 case, resistant to steroids, IVIg, and plasmapheresis, resulted in death. 16 Pregnancy is associated with a reduced inflammatory response due to increased levels of antiinflammatory and immunosuppressant cytokines which prevent fetal rejection and promote passive transfer of antibodies to the fetus.…”

Section: Discussionmentioning

confidence: 99%

Resolution of Acute Disseminated Encephalomyelitis Following Termination of Pregnancy

et al. 2014

View full text Add to dashboard Cite

“…After corticosteroids failed to improve her condition, the patient was treated with plasmapheresis, and the symptoms improved significantly for a period of time, showing that plasma exchange was important for improving the symptoms of ADEM. Gaudry et al (104) illustrated another case of ADEM diagnosed at 6 weeks of gestation. The patient had severe neurological impairment and cognitive symptoms.…”

Section: Adem and Pregnancymentioning

confidence: 99%

Pregnancy-Related Immune Changes and Demyelinating Diseases of the Central Nervous System

Qiu

Chen

et al. 2019

Front. Neurol.

View full text Add to dashboard Cite

Demyelinating diseases of the central nervous system comprise a heterogeneous group of autoimmune disorders characterized by myelin loss with relative sparing of axons occurring on a background of inflammation. Some of the most common demyelinating diseases are multiple sclerosis, acute disseminated encephalomyelitis, and neuromyelitis optica spectrum disorders. Besides showing clinical, radiological, and histopathological features that complicate their diagnosis, demyelinating diseases often involve different immunological processes that produce distinct inflammatory patterns. Evidence of demyelination diseases derives mostly from animal studies of experimental autoimmune encephalomyelitis (EAE), a model that relies on direct antibody–antigen interactions induced by encephalitogenic T cells. Pregnancy is characterized by non-self-recognition, immunomodulatory changes and an altered Th1/Th2 balance, generally considered a Th2-type immunological state that protects the mother from infections. During pregnancy, the immune response of patients with autoimmune disease complicated with pregnancy is different. Immune tolerance in pregnancy may affect the course of some diseases, which may reach remission or be exacerbated. In this review, we summarize current knowledge on the immune status during pregnancy and discuss the relationship between pregnancy-related immune changes and demyelinating diseases of the central nervous system.

show abstract

The follow-up of acute disseminated encephalomyelitis in a comatose pregnant woman

Cited by 5 publications

References 4 publications

Relationship Between Pregnancy and Acute Disseminated Encephalomyelitis: A Single-Case Study

Relationship Between Pregnancy and Acute Disseminated Encephalomyelitis: A Single-Case Study

Resolution of Acute Disseminated Encephalomyelitis Following Termination of Pregnancy

Pregnancy-Related Immune Changes and Demyelinating Diseases of the Central Nervous System

Contact Info

Product

Resources

About