Safe Childbirth in a Patient with Neuromyelitis Optica Spectrum Disorder Treated with Satralizumab

A 30-year-old woman presented with optic neuritis. On an examination, aquaporin-4 immunoglobulin G-positive neuromyelitis optica spectrum disorder (NMOSD) was diagnosed. Following immunotherapy for the NMOSD attack, prednisolone 20 mg was prescribed as maintenance therapy to prevent further relapse. Although the attacks recurred six times before and after her first delivery, none occurred after the addition of satralizumab. She became pregnant again at 41 years old and gave birth safely. No attacks occurred with prednisolone 10 mg and satralizumab. The concentration of satralizumab in the umbilical cord blood was approximately half that in the maternal serum, but the infant developed well with no malformations.