I am 38. Can infection and stress trigger my NMOSD relapses?

Question

Hello doctor,

I am a 38-year-old woman diagnosed with NMOSD (neuromyelitis optica spectrum disorder) after having repeated episodes of vision loss in one eye and weakness in my legs. My antibody tests came back positive for AQP4 (Aquaporin-4). I have been put on immunosuppressant medications, but I am worried about long-term side effects and increased infection risk. I am concerned about permanent disability if future relapses are not controlled. Please tell me,

How effective are the newer treatments like Eculizumab or Inebilizumab in preventing relapses?
Could stress or certain infections trigger another attack?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Experiencing repeated vision loss and weakness at a young age can leave anyone feeling anxious about the future. Your AQP4 (Aquaporin-4) antibody came back positive, which confirms the diagnosis. But it also means you have access to highly effective modern treatments that were not available years ago.

The newer therapies containing monoclonal antibodies, such as Eculizumab, Inebilizumab, and Satralizumab, have changed the outlook for people with AQP4-positive NMOSD (neuromyelitis optica spectrum disorder) in a very meaningful way.

Eculizumab has been shown to reduce relapse risk by more than ninety-five percent in many patients, which is an enormous improvement compared to older immunosuppressants.

Inebilizumab, which targets B cells, has also been very effective in lowering relapse rates and helping patients stay stable over years of follow-up.

These medications come with some infection risks and require monitoring, but their ability to prevent disability is strong and often life-changing. Many people who switch to these treatments experience long periods of remission with no new attacks.

Stress, high fever, and certain infections can act as triggers for relapses because they activate the immune system. There you can follow the steps below,

Managing stress.
Treating infections early.
Keeping your body as stable as possible

It will help reduce risks, although they cannot eliminate them. The most important protection you can give yourself is staying on a reliable preventive therapy.

The fear of permanent disability is completely understandable because relapses in NMOSD can leave lasting damage. With the proper long-term treatment, relapse prevention is now much more successful than it used to be, and many patients maintain good function for decades.

With close follow-up, the right medication plan, and prompt attention to any new symptoms or infections, you have a strong chance of keeping this disease under control and preserving your quality of life.

I hope this information helps you.

Feel free to ask further queries.

Thank you.