RESUMEN
OBJECTIVES: To report the results from the Brazilian database on multiple sclerosis (MS) and pregnancy. METHODS: Retrospective data from MS patients who became pregnant at any time of their disease were sent to a Brazilian database, using a specific file for this purpose. RESULTS: Data on 128 women (142 pregnancies) from 30 neurologists working in 21 cities in Brazil were collected. Patients' average age at pregnancy was 29.8 years (range 16-42). EDSS at start of pregnancy was 1.5±1.4; and the relapse rate in the year preceding pregnancy was 1.2±1.5. Exposure to medication at any time during pregnancy was high (69.7%): 48.6% to interferon beta; 14.1% to glatiramer acetate; and 7% to other immunomodulatory and immunosuppressive drugs. There was a significant decrease in relapse rate during pregnancy. The prevalence of complications was relatively low, with 4.9% of obstetric and 1.4% neonatal unfavorable outcomes. CONCLUSIONS: Our patients had low degrees of disability, short histories of disease, high drug exposure, and relatively high relapse rate in the year previous to pregnancy. Obstetric and neonatal outcomes were successful in over 90% of our patients.
Asunto(s)
Esclerosis Múltiple/epidemiología , Complicaciones del Embarazo/epidemiología , Adolescente , Adulto , Peso al Nacer/efectos de los fármacos , Brasil/epidemiología , Interpretación Estadística de Datos , Bases de Datos Factuales , Femenino , Acetato de Glatiramer , Humanos , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Recién Nacido , Enfermedades del Recién Nacido/epidemiología , Interferón Tipo I/efectos adversos , Interferón Tipo I/uso terapéutico , Esclerosis Múltiple/tratamiento farmacológico , Péptidos/efectos adversos , Péptidos/uso terapéutico , Embarazo , Resultado del Embarazo , Proteínas Recombinantes , Recurrencia , Estudios Retrospectivos , Adulto JovenRESUMEN
A 73 year-old white male, living in the interior of the state of Mato Grosso do Sul, in central Brazil, after an initial diagnosis of sinusitis was transferred to the neurology service with a 3-day evolution of intracranial hypertension. Exams showed lymphocytic leukemia and a tumor-like lesion, either an expanding inflammatory process such as an abscess or a neoplasm. Treatment with Ceftriaxone and Decadron was started and intracranial hypertension was controlled. Methotrexate was injected on the occasion of the next puncture considering a possible leukemia infiltration. Flagellate forms of T. cruzi were observed in the CSF and treatment with Benznidazole was started. After 4 days the CSF presented fractionated forms of trypomastigotes. The protein level was 27%. Signs of intracranial hypertension ceased. Tomography and magnetic resonance images showed an important reduction of the tumor-like lesion. The clinical condition of the patient improved.
