Cargando…

Myointimal Hyperplasia in a Patient with Neuromyelitis Optica (Devic's Disease) after the Creation of an Arteriovenous Graft

Neuromyelitis optica, also known as Devic's disease, is an autoimmune disorder that leads to the inflammation and demyelination of nerves. Devic's disease primarily affects the optic nerve and spinal cord, but can lead to a significant loss of function throughout the body if not treated wi...

Descripción completa

Detalles Bibliográficos
Autores principales: Rao, Christina, Fox, Stephanie, Desai, Sapan S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803718/
https://www.ncbi.nlm.nih.gov/pubmed/29422845
http://dx.doi.org/10.1159/000480230
_version_ 1783298701817544704
author Rao, Christina
Fox, Stephanie
Desai, Sapan S.
author_facet Rao, Christina
Fox, Stephanie
Desai, Sapan S.
author_sort Rao, Christina
collection PubMed
description Neuromyelitis optica, also known as Devic's disease, is an autoimmune disorder that leads to the inflammation and demyelination of nerves. Devic's disease primarily affects the optic nerve and spinal cord, but can lead to a significant loss of function throughout the body if not treated with steroid therapy or plasmapheresis. We recently saw a 62-year-old patient who received plasmapheresis for Devic's disease through a PTFE arteriovenous graft in her left arm. Her graft clotted without warning, and percutaneous thrombolysis was not successful. A new vascular access was achieved with the use of an immediate-cannulation PTFE graft, and the patient received plasmapheresis immediately after her operation. However, the patient returned within 2 weeks with a thrombosed graft. Extensive myointimal fibrosis was noted within the brachial artery and axillary vein during a graft thrombectomy. Subsequent placement of a new arteriovenous fistula in her contralateral arm was eventually successful. Myointimal fibrosis may be a sequela of symptomatic antibody-positive Devic's disease, and avoidance of synthetic materials may be indicated in this patient population to avoid exacerbation of an autoimmune response.
format Online
Article
Text
id pubmed-5803718
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher S. Karger AG
record_format MEDLINE/PubMed
spelling pubmed-58037182018-02-08 Myointimal Hyperplasia in a Patient with Neuromyelitis Optica (Devic's Disease) after the Creation of an Arteriovenous Graft Rao, Christina Fox, Stephanie Desai, Sapan S. Case Rep Neurol Case Report Neuromyelitis optica, also known as Devic's disease, is an autoimmune disorder that leads to the inflammation and demyelination of nerves. Devic's disease primarily affects the optic nerve and spinal cord, but can lead to a significant loss of function throughout the body if not treated with steroid therapy or plasmapheresis. We recently saw a 62-year-old patient who received plasmapheresis for Devic's disease through a PTFE arteriovenous graft in her left arm. Her graft clotted without warning, and percutaneous thrombolysis was not successful. A new vascular access was achieved with the use of an immediate-cannulation PTFE graft, and the patient received plasmapheresis immediately after her operation. However, the patient returned within 2 weeks with a thrombosed graft. Extensive myointimal fibrosis was noted within the brachial artery and axillary vein during a graft thrombectomy. Subsequent placement of a new arteriovenous fistula in her contralateral arm was eventually successful. Myointimal fibrosis may be a sequela of symptomatic antibody-positive Devic's disease, and avoidance of synthetic materials may be indicated in this patient population to avoid exacerbation of an autoimmune response. S. Karger AG 2017-11-10 /pmc/articles/PMC5803718/ /pubmed/29422845 http://dx.doi.org/10.1159/000480230 Text en Copyright © 2017 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Rao, Christina
Fox, Stephanie
Desai, Sapan S.
Myointimal Hyperplasia in a Patient with Neuromyelitis Optica (Devic's Disease) after the Creation of an Arteriovenous Graft
title Myointimal Hyperplasia in a Patient with Neuromyelitis Optica (Devic's Disease) after the Creation of an Arteriovenous Graft
title_full Myointimal Hyperplasia in a Patient with Neuromyelitis Optica (Devic's Disease) after the Creation of an Arteriovenous Graft
title_fullStr Myointimal Hyperplasia in a Patient with Neuromyelitis Optica (Devic's Disease) after the Creation of an Arteriovenous Graft
title_full_unstemmed Myointimal Hyperplasia in a Patient with Neuromyelitis Optica (Devic's Disease) after the Creation of an Arteriovenous Graft
title_short Myointimal Hyperplasia in a Patient with Neuromyelitis Optica (Devic's Disease) after the Creation of an Arteriovenous Graft
title_sort myointimal hyperplasia in a patient with neuromyelitis optica (devic's disease) after the creation of an arteriovenous graft
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803718/
https://www.ncbi.nlm.nih.gov/pubmed/29422845
http://dx.doi.org/10.1159/000480230
work_keys_str_mv AT raochristina myointimalhyperplasiainapatientwithneuromyelitisopticadevicsdiseaseafterthecreationofanarteriovenousgraft
AT foxstephanie myointimalhyperplasiainapatientwithneuromyelitisopticadevicsdiseaseafterthecreationofanarteriovenousgraft
AT desaisapans myointimalhyperplasiainapatientwithneuromyelitisopticadevicsdiseaseafterthecreationofanarteriovenousgraft