Obstet Gynecol 2001 Nov;98(5 Pt 2):902-4
Retzloff MG, Kobylarz EJ, Eaton
C.
Brigham and Women's Hospital, Harvard
Medical School, Boston, Massachusetts, USA
BACKGROUND:
Lactation-induced blindness is a
rare but devastating puerperal complication. There are few reported cases
and no consistent associated disease processes historically identified.
This case illustrates lactation-associated optic neuritis as an early identifier
of multiple sclerosis.
CASE:
A nulliparous woman underwent a term
vaginal delivery complicated only by chorioamnionitis. She was treated
with intravenous antibiotics, which included spontaneous bacterial endocarditis
prophylaxis. Her postpartum course was uncomplicated, and she was discharged
on postpartum day 2 with her infant. She was readmitted on postpartum day
16 completely blind. Evaluation revealed bilateral optic neuritis. Symptoms
were initiated and exacerbated during nursing. Transitory waxing and waning
of her visual deficits were noted after aggressive steroid therapy and
discontinuing nursing. The patient was subsequently diagnosed with multiple
sclerosis of relapsing-remitting type.
CONCLUSION:
Multiple sclerosis must be considered
as an etiology for acute puerperal lactation-associated blindness when
there is no clear anatomic or infectious cause.
PMID: 11704195 [PubMed - in process]