{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:21:20Z","timestamp":1786969280063,"version":"build-2736575974"},"reference-count":12,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2025,5,26]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>\n                    Complement inhibition is a highly effective strategy for preventing relapse and disability accumulation in neuromyelitis optica spectrum disorder (NMOSD). Invasive infection with\n                    <jats:italic>Neisseria meningitidis<\/jats:italic>\n                    , the principal risk of complement inhibition, is largely mitigated by adequate vaccination. However, vaccination in the context of treatment sequencing from other immunosuppressive therapies, in particular rituximab, presents unique challenges. We present a 17-year-old woman with a severe NMOSD relapse despite B-cell depletion, who subsequently developed meningococcal sepsis after treatment with ravulizumab, despite prior vaccination; and we propose strategies to manage risk in this patient population.\n                  <\/jats:p>","DOI":"10.1136\/pn-2025-004651","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T13:20:30Z","timestamp":1750857630000},"page":"553-557","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Ravulizumab-related meningococcal sepsis post rituximab"],"prefix":"10.1136","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6151-4859","authenticated-orcid":false,"given":"Katharine","family":"Kline","sequence":"first","affiliation":[{"name":"Department of Neurology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Raleigh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Beadnall","sequence":"additional","affiliation":[{"name":"Department of Neurology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia"},{"name":"Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith M","family":"Spies","sequence":"additional","affiliation":[{"name":"Department of Neurology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW, 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Sydney, Camperdown, NSW, Australia"},{"name":"Department of Neurology and Neuroscience, University of Freiburg, Freiburg, BW, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Barnett","sequence":"additional","affiliation":[{"name":"Department of Neurology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia"},{"name":"Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"2025111304551246000_25.6.553.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.102175"},{"key":"2025111304551246000_25.6.553.2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26626"},{"key":"2025111304551246000_25.6.553.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1900866"},{"key":"2025111304551246000_25.6.553.4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-05-781450"},{"key":"2025111304551246000_25.6.553.5","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-04-494096"},{"key":"2025111304551246000_25.6.553.6","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.211152"},{"key":"2025111304551246000_25.6.553.7","doi-asserted-by":"crossref","first-page":"2357","DOI":"10.1111\/ene.15830","article-title":"Antibody response elicited by the SARS-CoV-2 vaccine booster in patients with multiple sclerosis: Who gains from it?","volume":"30","author":"Schiavetti","year":"2023","journal-title":"Eur J Neurol"},{"key":"2025111304551246000_25.6.553.8","doi-asserted-by":"crossref","first-page":"104079","DOI":"10.1016\/j.msard.2022.104079","article-title":"Humoral response to COVID-19 vaccination in MS patients on disease modifying therapy: Immune profiles and clinical outcomes","volume":"67","author":"Holroyd","year":"2022","journal-title":"Mult Scler Relat Disord"},{"key":"2025111304551246000_25.6.553.9","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4146-5"},{"key":"2025111304551246000_25.6.553.10","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6627e1"},{"key":"2025111304551246000_25.6.553.11","doi-asserted-by":"crossref","first-page":"103143","DOI":"10.1016\/j.msard.2021.103143","article-title":"Relapses shortly after rituximab treatment in neuromyelitis optica spectrum disorder","volume":"54","author":"Shi","year":"2021","journal-title":"Mult Scler Relat 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