2018, Number 3
<< Back
Rev Mex Neuroci 2018; 19 (3)
Amyotrophic Lateral Sclerosis during pregnancy an uncommon association
Castro-Macías JI, Santos-Vázquez G, Díaz-Campos MO, Quijas-Aldana I, García-Cázarez R
Language: Spanish
References: 32
Page: 95-102
PDF size: 208.24 Kb.
ABSTRACT
Background: Amyotrophic lateral sclerosis (ALS) is a progressive
neurodegenerative disease that shows a combination of upper and
lower motor neurons signs and symptoms. The association of ALS and
pregnancy has low prevalence due to demographic characteristics of
the disease.
Case: A 29-year-old woman, healthy, who comes to the clinic at week
29 of gestation, manifests progressive weakness, distal hypotrophy,
and dysphagia. On examination signs of upper and lower motor neuron
with involvement in cervical, bulbar, thoracic and lumbar segments.
The pregnancy developed without complications; adequate prenatal
control, and cesarean section as resolution of pregnancy.
Conclusion: Pregnancy may be associated with the development
of latent ALS due to hormonal factors related to the increase of
progestogens, which would decrease the neuroprotective effect of
estrogens, being the trigger of the disease. Vaginal delivery is facilitated,
but respiratory compromise would determine the cesarean delivery.
REFERENCES
Kiernan MC, Vucic S, Cheah BC, Turner MR, Eisen A, Hardiman O, et al. Amyotrophic lateral sclerosis. Lancet. 2011;377(9769):942-55.
Al-Chalabi A, Hardiman O, Kiernan MC, Chiò A, Rix-Brooks B, van den Berg LH. Amyotrophic lateral sclerosis: moving towards a new classification system. Lancet Neurol. 2016;15(11):1182-94.
Chiò A, Calvo A, Di Vito N, Vercellino M, Ghiglione P, Terreni AA, et al. Amyotrophic lateral sclerosis associated with pregnancy: report of four new cases and review of the literature. Amyotroph Lateral Scler Other Mot Neuron Disord. 2003;4(1):45-48.
Sarafov S, Doitchinova M, Karagiozova Z, Slancheva B, Dengler R, Petri S, et al. Two consecutive pregnancies in early and late stage of amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2009;10(5- 6):483-6.
Scalco RS, Vieira MC, da Cunha Filho EV, Lago EG, da Silva IG, Becker J. Amyotrophic lateral sclerosis and riluzole use during pregnancy: A case report. Amyotroph Lateral Scler. 2012;13(5):471-2.
Huston J, Lingenfelder J, Mulder D, Kurland L. Pregnancy complicated by amyotrophic lateral sclerosis. Am J Obstet Gynecol. 1956;72(1):93-9.
Levine MC, Michels RM. Pregnancy and amyotrophic lateral sclerosis. Ann Neurol. 1977;1(4):408.
Lupo VR, Rusterholz JH, Reichert JA, Hanson SA. Amyotrophic lateral sclerosis in pregnancy. Obstet Gynecol. 1993;82(4):682-5.
Vincent O, Rodriguez-Ithurralde D. Amyotrophic lateral sclerosis and pregnancy. J Neurol Sci. 1995;129:42-3.
Jacka MJ, Sanderson F. Amyotrophic lateral sclerosis presenting during pregnancy. Anesth Analg. 1998;86(3):542-3.
Sobrino-bonilla Y. Caring for a Laboring Women With Amyotrophic Lateral Sclerosis: A CASE REPORT. MCN Am J Matern Child Nurs. 2004;29(4):243-7.
Leveck DE, Davies GA. Rapid progression of amyotrophic lateral sclerosis presenting during pregnancy: a case report. J Obstet Gynaecol Can. 2005;27(4):360-2.
Ahmed WA, Morsy A, Hunter A. Motor neurone disease in pregnancy: A case report. SCU-MJ. 2008:137-9.
Martínez HR, Marioni SS, Ocañas CEE, Garza MTG, Moreno-Cuevas JE. Amyotrophic lateral sclerosis in pregnancy: clinical outcome during the post-partum period after stem cell transplantation into the frontal motor cortex. Cytotherapy. 2014;16(3):402-5.
Tyagi A, Sweeney B, Connolly S. Amyotrophic lateral sclerosis associated with pregnancy. Neurol India. 2001;49(4):413.
Hardiman O, Al-Chalabi A, Chio A, Corr E, Logroscino G, Robberecht W, et al. Amyotrophic lateral sclerosis. Nat Rev Dis Prim. 2017;3:17071.
Rudnicki SA. Estrogen replacement therapy in women with amyotrophic lateral sclerosis. J Neurol Sci. 1999;169(1):126-7.
Klemann CJHM, Visser JE, Van Den Bosch L, Martens GJM, Poelmans G. Integrated molecular landscape of amyotrophic lateral sclerosis provides insights into disease etiology. Brain Pathol. 2017; 28(2): 203-211.
Rooney JPK, Visser AE, D’Ovidio F, Vermeulen R, Beghi E, Chio A, et al. A case-control study of hormonal exposures as etiologic factors for ALS in women. Neurology. 2017;89(12):1283-1290.
de Jong S, Huisman M, Sutedja N, van der Kooi A, de Visser M, Schelhaas J, et al. Endogenous female reproductive hormones and the risk of amyotrophic lateral sclerosis. J Neurol. 2013;260(2):507-12.
Singer CA, Figueroa-Masot XA, Batchelor RH, Dorsa DM. The mitogen-activated protein kinase pathway mediates estrogen neuroprotection after glutamate toxicity in primary cortical neurons. J Neurosci. 1999;19(7):2455-63.
Groeneveld G, Van Muiswinkel F, Sturkenboom J, Wokke J, Bär P, Van den Berg L. Ovariectomy and 17β-estradiol modulate disease progression of a mouse model of ALS. Brain Res. 2004;1021(1):128- 31.
Jayaraman A, Pike CJ. Progesterone attenuates oestrogen neuroprotection via downregulation of oestrogen receptor expression in cultured neurones. J Neuroendocrinol. 2009;21(1):77-81.
Monachelli GG, Meyer M, Rodríguez G, Garay L, Sica RE, De Nicola AF, et al. Progesterone and cortisol levels in sporadic amyotrophic lateral sclerosis (sALS): correlation with prognostic factors. Horm Mol Biol Clin Investig. 2011;6(1):167-173.
Kim J, Kim TY, Cho KS, Kim HN, Koh JY. Autophagy activation and neuroprotection by progesterone in the G93A-SOD1 transgenic mouse model of amyotrophic lateral sclerosis. Neurobiol Dis. 2013;59:80- 85.
Philips T, Robberecht W. Neuroinflammation in amyotrophic lateral sclerosis: role of glial activation in motor neuron disease. Lancet Neurol. 2011;10(3):253-63.
Lunetta C, Sansone V, Penco S, Mosca L, Tarlarini C, Avemaria F, et al. Amyotrophic lateral sclerosis in pregnancy is associated with a vascular endothelial growth factor promoter genotype. Eur J Neurol. 2014;21(4):594-8.
Paez-Colasante X, Figueroa-Romero C, Sakowski SA, Goutman SA, Feldman EL. Amyotrophic lateral sclerosis: mechanisms and therapeutics in the epigenomic era. Nat Rev Neurol. 2015;11(5):266-279.
Jimenez-Pacheco A, Franco JM, Lopez S, Gomez-Zumaquero JM, Leal-Lasarte MM, Caballero- Hernandez DE et al. Epigenetic mechanisms of gene regulation in amyotrophic lateral sclerosis. Neuroepigenomics in Aging and Disease. 2017:255-275.
McCombe PA, Henderson RD. Effects of gender in amyotrophic lateral sclerosis. Gend Med. 2010;7(6):557-70.
Fuller PI, Reddrop C, Rodger J, Bellingham MC, Phillips JK. Differential expression of the NMDA NR2B receptor subunit in motoneuron populations susceptible and resistant to amyotrophic lateral sclerosis. Neurosci Lett. 2006;399(1):157-61.
Kawamichi Y, Makino Y, Matsuda Y, Miyazaki K, Uchiyama S, Ohta H. Riluzole use during pregnancy in a patient with amyotrophic lateral sclerosis: a case report. J Int Med Res. 2010;38(2):720-6.