Immunoadsorption Plasma Pheresis Therapy for Neuromyelitis Optica(Special Issue in Hornor of the Retirement of Professor Makoto Iwata at the Department of Neurology, Tokyo Women's Medical University)

Neuromyelitis optica (NMO) is an idiopathic inflammatory demyelinating disease of the central nervous system characterized by optic neuritis and myelitis. Recently, anti aquaporin-4 antibody, specifically detected in sera from NMO patients, was discovered. The effectiveness of immunoadsorption plasma pheresis (IAPP) therapy for treating acute exacerbations of NMO has not been well evaluated; thus, accumulation of therapeutic experience for this disease is important. We report 3 patients with acute exacerbations of NMO. These patients were unresponsive to intravenous methylprednisolone therapy but showed significant improvement after IAPP therapy. IAPP therapy was well tolerated and effective for a patient with acute exacerbation during pregnancy. We conclude that IAPP therapy is a therapeutic option for patients with a fulminant attack of NMO. It is relatively safe and applicable for patients with acute exacerbation during pregnancy