Severe Multiple Sclerosis Manifesting upon GnRH Agonist Therapy for Uterine Fibroids

Abstract

This case concerned a 39-year-old woman diagnosed with uterine fibroids. Upon initiation of gonadotropin-releasing hormone (GnRH) agonist therapy, she experienced various neurological deficits but did not seek medical attention because of gradual spontaneous symptom improvement. Upon completing four courses of GnRH agonist therapy, she began experiencing severe neurological symptoms and was diagnosed with multiple sclerosis (MS). Although her symptoms improved with steroid pulse therapy, serious sequelae remained. GnRH agonist therapy can exacerbate the disease activity of MS; therefore, awareness of the potential emergence of neurological symptoms during GnRH agonist therapy is important.