Vitamin D is an important regulator of the immune system and it has been shown that deficiency of Vitamin D is significant environmental factor in some immune-mediated diseases such as multiple sclerosis (MS). In this study we aimed to detect 25-0H Vitamin D levels in patients with relapsing remitting multiple sclerosis and also in patients with clinically isolated syndrome (CIS).Patients who have been fallowing in our multiple sclerosis unit, between 18-45 years, were included to the study. Serum 25-OH Vitamin D, calcium, phosphorus , alkaline phosphatase, parathyroid hormone, insülin and glucose levels were detected in 40 MS patients, 40 CIS patients and 60 healthy volunteers and were compared among the groups. Disease duration, number of relapses,T2 hyperintense lesion load in cranial magnetic resonance imaging (MRI), existence of lesion in cervical MRI, and CIS attack type were also recorded.25-OH Vitamin D levels were significantly lower in RRMS and CIS groups than controls. No significant difference was found among the patien' groups. No statistically significant correlations were detected between the levels of vitamin D and other biochemical, clinical and radiological parameters.As far as we know, this is the first Vitamin D study in CIS. It appears that Vitamin D levels are low at the early stages of the demyelinating process. Replacement vitamin D therapy might be important for prevention of MS.The most frequent debut of MS is noted in ages from 18 to 45 yearsthe active childbearing period. Data on the effect of pregnancy on the course of MS are contradictory. Retrospective analyses of data from the Russian MS register of 279 women with MS having from 1 to 4 children at the start of the study. We assessed the number of exacerbations during pregnancy, the risks of exacerbations after abortion, during pregnancy and in the postpartum period, as well as the effects of disease modifying treatment (DMT).The average age of onset of MS was 24.24 ± 6.47, frequency of exacerbations(AFE) in the two years before the pregnancy was 1.02 ± 0.63, the average score of EDSS scale before the pregnancy-1.94 ± 0.63. Before pregnancy 183 patients (65,6%) treated by DMT, which was stopped by the fact of pregnancy. During pregnancy the AFE significantly decreased (p b 0.05): 1-st trimester-0.13 ± 0.4, 2-nd trimester-0.08 ± 0.31, 3-rd trimester-0.03 ± 0.19. We noted lower AFE in the period up to 3 month after delivery compared with the data before the pregnancy-0.24 ± 0.51. The EDSS increased after delivery to 2.13 ± 0.68( p b 0.05) which was due to increase disease activity in the period up to the 3-rd month after the delivery (Spearman R 0.146,p = 0.015). Causes of lower AFE after delivery than before pregnancy: early beginning therapy by DMT(about 3,19 ± 3,52 month)-Spearman R = -2,32,(p = 0.02); positive patient's DMT anamnesis before the pregnancy (χ2 = 38.44,p b 0.05). Type of delivery didn't influence the rate of development and severity of exacerbation. The course of the pregnancy and delivery in patients with MS is the ...
