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Multiple Sclerosis


Table 1: Overview of Some of the More Frequent Autoimmune Conditions and their Degree of Association with MS Condition


Description


Autoimmune hepatitis Rare event, but should be considered when re-exposing MS patients with previous hepatic damage to immunomodulatory drugs


Autoimmune thyroiditis Inflammation of the thyroid and decrease in thyroxin secreted. Significantly more prevalent in male MS patients than in male controls (9.4 versus 1.9 %; p=0.03).


Studies are needed to show whether autoimmune thyroiditis influences disease progression


Guillain–Barré syndrome Acute inflammatory demyelinating polyneuropathy of the peripheral nervous system, causing weakness and more serious damage to the autonomic system


Inflammatory bowel disease


Genetic evidence suggests that


inflammatory bowel disease and systemic lupus erythematosus are linked. One case has been reported of an MS patient who developed ulcerative colitis following treatment with IFNβ-1a. An Australian registry study found an association between ulcerative colitis and MS


Scleroderma Type 1 diabetes Uveitis


Cases of scleroderma developing following 0.06 MS have been reported


A Sardinian cohort study found a fivefold higher prevalence of diabetes in MS patients than in the general population Well-documented association between uveitis and MS. Occurrence varies widely,


between 0.4 and 26.9 %. IFNβ-1a has been found to be beneficial in the treatment of MS-associated uveitis


Psoriasis


A recent systematic review of the literature 1.3 concluded that psoriasis does not appear


to be more common in patients with MS or their relatives


Rheumatoid arthritis MS and rheumatoid arthritis appear to have 0.83 a reduced chance of coexistence


0.86 1.0 (0.7–1.3) Nielsen, et al.,


2006;25 Cooper, et al., 2009;26 Somers, et al., 200927


Asthma (without chronic obstructive pulmonary disease)


Systemic lupus erythematosus


A large North American study found no association between MS and asthma. However, a retrospective study in Wales established an inverse


relationship between asthma and MS A recent American population-based case-control study found no increased


likelihood of MS patients having or developing systemic lupus erythematosus


CI = confidence interval; IFNβ = interferon beta; MS = multiple sclerosis; OR = odd ratio. Frequency and adjusted ORs of autoimmune comorbidities prior to MS diagnosis taken from a population study of MS patients enrolled in a medical care program (i.e., Northern California Kaiser Permanente [NCKP] medical care program) compared with matched controls. ORs adjusted for age, gender, and NCKP membership duration. p-values >0.20 not reported. Source: Langer-Gould, et al., 2010.24


2.8 3.0 0.9 (0.8–1.1)


Langer-Gould, et al., 2010;24


Tremlett, et al., 200229


0.4 0.3 1.3 (0.8–2.2)


Langer-Gould, et al., 201024


1.2 1.1 (0.8–1.4)


Kwok, et al., 201077


0.85 1.3 0.06 0.9 0.6 0.1 0.02


5.0 (1.6–15.4) p=0.006


Langer-Gould, et al., 2010;24 Flachenecker, 200770


0.8 0.45


1.7 (1.2–2.5) p=0.002


Marrie and Horwitz, 2010;33


Frequency in MS Frequency in 0.02 Adjusted OR


Prior to Diagnosis (%) Matched Controls (95% CI); p-value 0.06


2.5 (0.6–9.9) p=0.20


0.17 0.18 1.0 (0.5–1.9) Reference


Deltenre, et al., 2009;68


von Kalckreuth, et al., 200869 Niederwieser, et al., 2003;28 Rotondi, et al., 201161


Schott, et al., 2007;59


De Jager, et al., 2006;71


Pokorny, et al., 200772


1.0 (0.3–3.4) 0.9 (0.7–1.3)


2.2 (1.7–2.9) p<0.001


Jawad, et al., 1997;73


et al., 198674


Marrosu, et al., 200275


Becker, et al., 200576


Trostle,


134


US NEUROLOGY


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