title: Accidental natalizumab administration to the third trimester of pregnancy in an adolescent patient with multiple sclerosis.
abstract: BACKGROUND
  Natalizumab is neither licensed for the use in adolescents nor during pregnancy. There are no reports of accidental natalizumab exposure during pregnancy continued as long as to the third trimester of pregnancy.
  
  
  OBJECTIVE
  We report the outcome of pregnancy in a 17-year-old adolescent patient with multiple sclerosis (MS) treated with natalizumab from the age of 16, who was diagnosed to be pregnant in the 31st gestational week (gw) of pregnancy. To our knowledge, this report describes the first patient receiving natalizumab to the third trimester of pregnancy.
  
  
  METHODS
  Because of high relapse activity, natalizumab treatment was administered in an adolescent patient with MS. Pregnancy was diagnosed in the 31st gw after 17 natalizumab infusions, seven of them accidentally during pregnancy.
  
  
  RESULTS
  Pre- and postnatal development of the child was normal.
  
  
  CONCLUSIONS
  The case reported indicates that accidentally continued natalizumab treatment until few weeks before delivery may have no negative impact on the developing foetus.
authors.affiliation: Department of Neurology Klinikum Augsburg, Germany. antonios.bayas@klinikum-augsburg.de
authors.forename: A
authors.initials: A
authors.lastname: Bayas
authors.forename: J
authors.initials: J
authors.lastname: Penzien
authors.forename: K
authors.initials: K
authors.lastname: Hellwig
mesh_terms: D000293:Adolescent; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005260:Female; D047109:Fetal Development / Q000187:drug effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000188:drug therapy*; D000069442:Natalizumab; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab