Two cases of anaphylactic shock by methylprednisolone in neuromyelitis optica

Mult Scler. 2018 Oct;24(11):1514-1516. doi: 10.1177/1352458518763099. Epub 2018 Apr 19.

Abstract

Steroid pulse therapy with methylprednisolone (mPSL) succinate ester is the most common treatment for neuromyelitis optica (NMO); no cases of anaphylaxis have been reported to date. Here, we report two cases of anaphylactic shock induced by mPSL pulse therapy in patients with NMO and concurrent systemic lupus erythematosus. Both patients had received several courses of mPSL pulse therapy without any problems previously. Repeated mPSL pulse therapy and comorbid humoral autoimmune disease might increase the risk of anaphylaxis. Corticosteroids without succinate esters should be considered as an alternative therapy to prevent anaphylaxis.

Keywords: Neuromyelitis optica; anaphylactic shock; betamethasone; methylprednisolone; succinate ester.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anaphylaxis / chemically induced*
  • Anti-Inflammatory Agents / adverse effects*
  • Comorbidity
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / epidemiology
  • Methylprednisolone / adverse effects*
  • Neuromyelitis Optica / drug therapy*
  • Neuromyelitis Optica / epidemiology

Substances

  • Anti-Inflammatory Agents
  • Methylprednisolone