-Purpose: Pregnancy management poses an extra challenge to physicians and their multiple sclerosis (MS) patients. There are few papers reporting databases on the subject. Method: Brazilian database from nine MS clinical and research units, with complete data on 47 pregnant women (49 pregnancies). Results: Despite relatively high exposure to MS medications, no birth defects were reported. Low birth weight and prematurity were similar to those for developing countries. Three complications may have been associated with these medications, while three others were considered to be of purely obstetric nature. Conclusion: Our results confirm previous findings on lower relapse rate during pregnancy and add to the present literature informing on data related to drug exposure.Key wOrDS: multiple sclerosis, pregnancy, prematurity, low birth weight, obstetric complications, interferon beta, glatiramer acetate. gravidez e esclerose múltipla: resultados preliminares de base de dados Brasileira resumo -Propósito: O manejo da gravidez cria um desafio extra aos médicos e aos pacientes com esclerose múltipla (eM). existem poucos trabalhos relatando bases de dados neste tema. Método: Base de dados brasileira de nove centros clínicos e de pesquisa na eM, com dados completos de 47 mulheres grávidas (49 gestações). Resultados: Apesar da exposição a drogas para eM ter sido relativamente alta, não foram registradas malformações. Baixo peso e prematuridade foram semelhantes àqueles de países em desenvolvimento. Três complicações podem ter sido associadas a drogas, enquanto outras três foram consideradas como sendo de natureza puramente obstétrica. Conclusão: Nossos resultados confirmam os achados de menor taxa de surtos na gestação e adicionam dados relacionados a exposição a drogas, na literatura atual.PALAvrAS-chAve: esclerose múltipla, gravidez, prematuridade, baixo peso, complicações obstétricas, interferon beta, acetato de glatirâmer.
BackgroundNeuromyelitis optica (NMO) is considered relatively more common in non-Whites, whereas multiple sclerosis (MS) presents a high prevalence rate, particularly in Whites from Western countries populations. However, no study has used ancestry informative markers (AIMs) to estimate the genetic ancestry contribution to NMO patients.MethodsTwelve AIMs were selected based on the large allele frequency differences among European, African, and Amerindian populations, in order to investigate the genetic contribution of each ancestral group in 236 patients with MS and NMO, diagnosed using the McDonald and Wingerchuck criteria, respectively. All 128 MS patients were recruited at the Faculty of Medicine of Ribeirão Preto (MS-RP), Southeastern Brazil, as well as 108 healthy bone marrow donors considered as healthy controls. A total of 108 NMO patients were recruited from five Neurology centers from different Brazilian regions, including Ribeirão Preto (NMO-RP).Principal FindingsEuropean ancestry contribution was higher in MS-RP than in NMO-RP (78.5% vs. 68.7%) patients. In contrast, African ancestry estimates were higher in NMO-RP than in MS-RP (20.5% vs. 12.5%) patients. Moreover, principal component analyses showed that groups of NMO patients from different Brazilian regions were clustered close to the European ancestral population.ConclusionsOur findings demonstrate that European genetic contribution predominates in NMO and MS patients from Brazil.
We report on nine patients (eight cases of MS and one case of NMOSD) who presented a disease relapse in close temporal association with their first AZD1222 vaccination dose against COVID-19. These patients had been stable for a median period of six years, with no evidence of disease activity and no change in their medication. After a median of 13 days (7 to 25 days) from vaccination, they developed a new relapse with increased disability and new lesions on magnetic resonance imaging. Although exceedingly rare, this might be an adverse event of AZD1222.
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