Sclerosis Multiplex and Comorbidity with Another Autoimmune Disease
Authors:
J. Szilasiová 1; I. Lazúrová 2
Authors‘ workplace:
Neurologická klinika LF UPJŠ a FN L. Pasteura Košice
1; I. Interná klinika LF UPJŠ a FN L. Pasteura Košice
2
Published in:
Cesk Slov Neurol N 2009; 72/105(1): 51-56
Category:
Short Communication
Overview
Introduction:
The objective of the study was to assess concomitant incidence of multiple sclerosis (MS) with additional autoimmune diseases in our set of patients and to analyse, in more detail, the impact of such comorbidities on the course of the disease. Patient group and Methods: 256 patients with clinically definitive multiple sclerosis according to McDonald’s criteria. The patients were classified into two groups. Group 1: MS with an additional autoimmune disease. Group 2: SM without an additional autoimmune disease. Results: The average EDSS (Expanded Disability Status Scale) score in the patient set was 3.4 ± 1.4. 23 (8.9%) patients had a concomitant autoimmune disease, the incidence rate being as follows: autoimmune thyroid disease (AIT) – 16; celiac disease – 2, type I diabetes mellitus – 1, rheumatoid arthritis – 1, ulcerous colitis – 1, psoriasis vulgaris – 1, ankylosing spondylitis – 1, and autoimmune hemolytic anaemia – 1. Conclusion: The highest incidence of MS was in patients with concomitant autoimmune thyroid disease. The presence of an additional autoimmune disease did not have a major impact on the degree of functional impairment of patients as compared with the group of patients without any comorbidity. In all cases, autoimmune disease preceded the occurrence of multiple sclerosis.
Key words:
sclerosis multiplex – comorbidity – autoimmune diseases
Sources
1. Havrdová E. Roztroušená skleróza mozkomíšní. In: Havrdová et al. Neuroimunologie. Praha: Maxdorf 2001: 231–269.
2. Herrero Herranz E, Pardo LA, Gold R, Linker RA. Pattern of axonal injury in murine myelin oligodendrocyte glycoprotein induced experimental autoimmune encephalomyelitis: implications for multiple sclerosis. Neurobiol Dis 2008; 30(2): 162–173.
3. Bjartmar C, Wujek JR, Trapp BD. Axonal loss in the pathology of MS: consequences for understanding the progressive phase of the disease. J Neurol Sci 2003; 206(2): 165–171.
4. Kleinschnitz C, Meuth SG, Kieseier BC, Wiendl H. Immunotherapeutic approaches in MS: update on pathophysiology and emerging agents or strategies 2006. Endocr Metab Immune Disord Drug Targets 2007; 7(1): 35–63.
5. Rovaris M, Gambini A, Gallo A, Falini A, Ghezzi A, Benedetti B et al. Axonal injury in early multiple sclerosis is irreversible and independent of the short term disease evolution. Neurology 2005; 65(10): 1626–1630.
6. Compston A. Revisiting the pathogenesis of multiple sclerosis revisited. The Int MS J 2003; 10(1): 29–31.
7. Hemmer B, Cepok S, Nessler S, Sommer N. Pathogenesis of multiple sclerosis: an update on immunology. Curr Opin Neurol 2002; 15(3): 227–231.
8. Martin R, McFarland HF. Immunological aspects of experimental allergic encephalomyelitis and multiple sclerosis. Crit Rev clin Lab Sci 1995; 32(2): 121–182.
9. Broadley SA, Deans J, Sawcer SJ, Clayton D, Compston DA. Autoimmune disease in first-degree relatives of patients with multiple sclerosis. A UK survey. Brain 2000; 123(6): 1102–1111.
10. Niwa Y, Sakane T, Kanoh T, Shichijo S, Wiederhold MD, Yokoyama MM. Transient autoantibodies with elevated complement levels in common viral diseases. J Clin Lab Immunol 1984; 13(4): 183–188.
11. Somers EC, Thomas SL, Smeeth L, Hall AJ. Autoimmune diseases co-occuring within individuals and within families. a systematic review. Epidemiology 2006; 17(2): 202–217.
12. Hansen KE, Arnason J, Bridges AJ. Autoantibodies and common viral illness. Semin Arthritis Rheum 1998; 27(5): 263–271.
13. Niederwieser G, Buchinger W, Bonelli R, Berghold A, Reisecker F, Költringer P et al. Prevalence of autoimmune thyroiditis and non immune thyroid disease in multiple sclerosis. J Neurol 2003; 250(6): 672–675.
14. Rotondi M, Oliviero A, Profice P, Mone CM, Biondi B, Del Buono A et al. Occurrence of thyroid autoimmunity and dysfunction thougout a nine-month follow up in patients undergoing interferon beta therapy for multiple sclerosis. J Endocrinol Invest 1998; 21(11): 748–752.
15. McDonald WI, Compston A, Edan G, Goodkin D, Hantung HP, Lublin FD et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 2001; 50(1): 121–127.
16. Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the „McDonald Criteria“. Ann Neurol 2005; 58(6): 840–846.
17. Kurtzke RF. Rating neurologic impairmnent in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33(11): 1444–1452.
18. Lublin F, Reingold SC. Defining the clinical course of multiple sclerosis. Neurology 1996; 46(6): 907–911.
19. Babbe H, Roers A, Waisman A, Lassmann H, Goebels N, Hohlfeld R et al. Clonal expansion of CD8(+) T cells dominate the T cell infiltrate in active multiple sclerosis lesions as shown by micromanipulation and single cell polymerase chain reaction. J Exp Med 2000; 192(3): 393–404.
20. Henderson RD, Bain CJ, Pender MP. The occurrence of autoimmune diseases in patients with multiple sclerosis and their families. J Clin Neurosci 2000; 7(5): 434–437.
21. Rudick RA. Evolving concepts in the pathogenesis of multiple sclerosis and their therapeutic implications. J Neuroophthalmol 2001; 21(4): 279–283.
22. Utz U, McFarland HF. The role of T cells in multiple sclerosis: implications for therapies targeting the T cell receptor. J Neuropathol Exp Neurol 1994, 53(4): 351–358.
23. De Keyser. Autoimmunity in multiple sclerosis. Neurology 1988; 38(3): 371–374.
24. Seyfert S, Klapps P, Meisel C, Fischer T, Junghan U. Multiple sclerosis and other immunologic diseases. Acta Neurol Scand 1990; 81(1): 38–42.
25. Wynn DR, Rodriguez M, O’Fallon M, Kurland LT. A reappraisal of the epidemiology of multiple sclerosis in Olmsted County, Minnesota. Neurology 1990; 40(5): 780–786.
26. Heward J, Gough SC. Genetic susceptibility to the development of autoimmune disease. Clin Sci (Lond) 1997; 93(6): 479–491.
27. Kastrukoff L, Morgan N, Zecchini D, White R, Petkau AJ, Satoh J et al. A role for natural killer cells in the immunopathogenesis of multiple sclerosis. J Neuroimmunol 1998; 86(2): 123–133.
28. Wertman E, Zilber N, Abramsky O. An association between MS and type 1 diabetes mellitus. J Neurol 1992; 239(1): 43–45.
29. Rang EH, Brooke BN, Hermon-Taylor J. Association of ulcerative colitis with multiple sclerosis. Lancet 1982; 2(8297): 555.
30. Cendrowski W. Multiple sclerosis and psoriasis. Wiad Lek 1989; 42(9): 575–578.
31. Hnilica P, Ďurechová E, Podoba J, Rešetková E. Occurrence of diffuse lymphoid thyroiditis in goitres during long term iodine prophylaxis in our area. In: Ulrich FE, Schneyer U (eds). Endokrinologie interdisziplinär. Halle-Wittenberg: Martin Luther-Univ 1988: 39–41.
32. Jacobson DL, Gange SJ, Rose NR, Graham NM. Epidemiology and estimated population burden of selected autoimmune disease in the United States. Clin Immunol Immunopathol 1997; 84(3): 223–243.
33. Sládková V, Mareš J, Luběnová B, Kollárová K, Opavský R, Kaňovský P. Léky navozený systémový lupus erythematodes při terapii inteferonem beta 1b – kazuistika. Cesk Slov Neurol N 2008; 71/104(4): 487–489.
34. Karni A, Abramsky O. Association of MS with thyroid disorders. Neurology 1999; 53(4): 883–885.
35. Annunziata P, Lore‘ F, Venturini E, Morana P, Guarino E, Borghi S et al. Early synthesis and correlation of serum anti thyroid antibodies with clinical parameters in multiple sclerosis. J Neurol Sci 1999; 168(1): 32–36.
36. Kiessling WR, Pflughaupt KW. Antithyroid antibodies in multiple sclerosis. Lancet 1980; 1(8158): 41.
37. Durelli L, Ferrero B, Oggero A, Verdun E, Ghezzi A, Montanari E, Zaffaroni M. Liver and thyroid function and autoimmunity during interferon beta 1b treatment for MS. Neurology 2000; 57: 1363–1370.
38. Monzani F, Caraccio N, Casolaro A, Lombardo F, Moscato G, Murri L et al. Long term interferon beta 1b therapy for MS: is routine thyroid assessment always useful? Neurology 2000; 55(4): 549–552.
39. Tunbridge WM, Vanderpump MP. Population screening for autoimmune thyroid disease. Endocrinol Metab Clin North Am 2000; 29(2): 239–253.
40. Noble JA, Valdes AM, Cook M, Klitz W, Thomson G, Erlich HA. The role of HLA class II genes in insulin dependent diabetes mellitus: molecular analysis of 180 Caucasian, multiplex families. Am J Hum Genet 1996; 59(5): 1134–1148.
41. Brinar VV, Petelin Z, Brinar M, Djaković V, Zadro I, Vranjes D. CNS demyelination in autoimmune diseases. Clin Neurol Neurosurg 2006; 108(3): 318–326.
42. Kimura K, Hunter SF, Thollander MS, Loftus EV jr, Melton LJ jr, O‘Brien PC et al. Concurrence of inflammatory bowel disease and multiple sclerosis. Mayo Clin Proc 2000; 75(8): 802–806.
43. Sadovnick A, Paty D, Yannakoulias G. Concurrence of multiple sclerosis and inflammatory bowel disease. N Engl J Med 1989; 321(11): 762–763.
44. Collard RC, Koehler RP, Mattson DH. Frequency and significance of antinuclear antibodies in multiple sclerosis. Neurology 1997; 49(3): 857–861.
45. Ijdo JW, Conti Kelly AM, Greco P, Abedi M, Amos M, Provenzale JM et al. Anti phospholipid antibodies in patients with multiple sclerosis and MS like illnesses: MS or APS? Lupus 1999; 8(2): 109–115.
46. Scott TF. Diseases that mimic multiple sclerosis. Postgrad Med 1991; 89(8): 187–191.
47. Sommer H, Müller K, Kinnunen E. Myasthenia gravis associated with multiple sclerosis. Epidemiological survey and immunological findings. J Neurol Sci 1989; 89(1): 37–48.
48. Alexander EL, Malinow K, Lejewski JE, Jerdan MS, Provost TT, Alexander GE. Primary Sjörgen’s syndrome with central nervous system disease mimicking multiple sclerosis. Ann Intern Med 1986; 104(3): 323–330.
49. Coates T, Slavotinek JP, Rischmueller M, Schultz D, Anderson C, Dellamelva M et al. Cerebral white matter lesions in primary Sjogren’s syndrome: a controlled study. J Rheumatol 1999; 26(6):1301–1305.
50. McLean BN, Miller DH, Thompson EJ. Oligoclonal banding of IgG in CSF, blood-brain barrier function, and MRI findings in patients with sarcoidosis, systemic lupus erythematosus, and Behçet’s disease involving the nervous system. J Neurol Neurosurg Psychiatry 1995; 58(5): 548–554.
51. Scott F, Hess D, Brillman J. Antiphospholipid antibody syndrome mimicking multiple sclerosis clinically and by magnetic resonance imaging. Arch Intern Med 1994; 154(8): 917–920.
52. Szilasiová J, Klímová E, Szilasiová A, Čiderová A, Rosocha J. Neurologické prejavy u chorých s antifosfolipidovými protilátkami. Cesk Slov Neurol N 2001; 64/97(1): 31–35.
53. Reindl M, Linington C, Brehm U, Egg R, Dilitz E, Deisenhammer F et al. Antibodies against the myelin oligodendrocyte glycoprotein and the myelin basic protein in multiple sclerosis and other neurological diseases: a comparative study. Brain 1999; 122(11): 2047–2056.
54. Midgard R, Grønning M, Riise T, Kvåle G, Nyland H. Multiple sclerosis and chronic inflammatory diseases. A case-control study. Acta Neurol Scand 1996; 93(5): 322–328.
55. Klímová E. Sclerosis multiplex a autoimunitné ochorenia. Neurol pre prax 2005; 6(5): 255–257.
Labels
Paediatric neurology Neurosurgery NeurologyArticle was published in
Czech and Slovak Neurology and Neurosurgery
![Issue 1](https://www.prolekare.cz/media/cache/resolve/journal_issue/media/image_pdf/c75ed37d9a44b6e28b4667a6a3bc8933.jpeg)
2009 Issue 1
Most read in this issue
- Thrombotic Thrombocytopenic Purpura (TTP) in a Female Patient with Multiple Sclerosis – a Case Report
- Hereditary Neuropathy
- Prediction of Clinical Course of Herpes Simplex Encephalitis from Magnetic Resonance Imaging – a Case Report
- Differential Diagnosis of Neuroacanthocytosis