Relapse of neuromyelitis optica associated with oral progestin

Introduction

Neuromyelitis optica (NMO) is an autoimmune disease of the central nervous system (CNS) characterised by optic neuritis (ON) and severe myelitis. NMO is a sexually dimorphic disease, predominantly affecting women and is active throughout most of their childbearing years. Pregnancy and delivery might adversely affect the course of NMO1–3; in turn, NMO could affect the outcome of pregnancy.4 Further, immunological changes derived from high levels of oestrogen and progesterone during pregnancy might influence the outcomes of NMO. However, the effect of exogenous progesterone on NMO has not been reported. Here, we describe a female patient with NMO that relapsed after oral ingestion of progestin prescribed for her dysfunctional uterine bleeding.

Case report

A 41-year-old Chinese woman with a 14-year history of NMO (figure 1A, B) was admitted to the hospital on her fourth day of decreased visual acuity in the left...

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