Should we systematically test patients with clinically isolated syndrome for auto-antibodies?

Negrotto, Laura; Tur, Carmen; Tintoré, Mar; Arrambide, Georgina; Sastre‐Garriga, Jaume; Río, Jordi; Comabella, Manuel; Nos, Carlos; Galán, Ingrid; Vidal-Jordana, Ángela; Simon, Éva; Castilló, Joaquín; Palavra, Filipe; Mitjana, Raquel; Auger, Cristina; Montalbán, Xavier

doi:10.1177/1352458515575338

Cited by 11 publications

(7 citation statements)

References 37 publications

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“…Are they real false‐positive results or, as for autoantibodies sometimes present in MS patients (antinuclear antibodies, anti‐SSA, or anti‐SSB), are they a concurrent association without a necessarily clinical significance? [14]. The scarcity of MOG‐IgG among healthy individuals (less than 0.1%) appears to support the second hypothesis [15].…”

Section: Discussionmentioning

confidence: 86%

Relevance of kappa free light chains index in patients with aquaporin‐4 or myelin‐oligodendrocyte‐glycoprotein antibodies

Deschamps

Shor

Papeix

et al. 2023

Euro J of Neurology

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Background:The kappa free light chains index (κ-index) is increasing in importance as a fast, easy, cost-effective, and quantitative biomarker in multiple sclerosis (MS), which can replace cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCB) detection.In previous studies, controls often included mixed patients with several inflammatory central nervous system disorders. The aim of the present study was to assess the κ-index in patients with serum aquaporin-4 (AQP4)-IgG or myelin-oligodendrocyte-glycoprotein (MOG)-IgG. Methods:We analyzed CSF/serum samples of patients with AQP4-IgG or MOG-Ig and evaluated distinct κ-index cut-offs. We described clinical and magnetic resonance imaging (MRI) features of patients with the highest κ-index values. Results:In 11 patients with AQP4-IgG, median κ-index was 16.8 (range 0.2; 63) and 6/11 (54.5%) had κ-index >12. Among 42 patients with MOG-IgG, 2 had low positive MOG-IgG titers, were ultimately diagnosed with MS, and had a markedly increased κ-index (54.1 and 102.5 respectively). For the remaining 40 MOG-IgG-positive patients the median κ-index was 0.3 (range 0.1; 15.5). Some 6/40 (15%) and 1/40 (2.5%) patients had a κ-index >6 and >12, respectively. None fulfilled MRI dissemination in space and dissemination in time (DIS/DIT) criteria and the final diagnosis was MOG-IgG-associated disease (MOGAD) for these 40 patients. Four of the 40 (10%) MOG-IgG-positive patients had OCB.

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Section: Discussionmentioning

confidence: 86%

Relevance of kappa free light chains index in patients with aquaporin‐4 or myelin‐oligodendrocyte‐glycoprotein antibodies

Deschamps

Shor

Papeix

et al. 2023

Euro J of Neurology

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“…In a long-term follow-up study conducted with clinically isolated syndrome type MS patients, there was no significant correlation between ANA positivity and clinical, laboratory and radiological parameters, and also no significant difference between MS patients and the general population in the rate of patients with antibody positivity who developed autoimmune diseases. Thus, they concluded that autoantibody studies are not useful in the absence of clinical findings [11]. In another ACE -angiotensin-converting enzyme; aCL -anticardiolipin; AMA -anti-mitochondrial antibodies; ANA -anti-nuclear antibody; ANCA -antineutrophil cytoplasmic antibodies; Anti-SSB -anti-Sjögren's-syndrome-related antigen B; Anti-TPO -anti-thyroid peroxidase antibodies; Auto-Ab -autoantibody; DFS-70 -anti-dense fine speckled-70 antibodies; ENA -extractable nuclear antigen; LA -lupus anticoagulant; MS -multiple sclerosis steroid treatment, family history, presence of comorbidity, presence of autoimmune disease, or EDSS scores recorded at the end of the two-year follow-up period (p > 0.05).…”

Section: Resultsmentioning

confidence: 99%

“…The rate of MS patients with ANA positivity reported in the literature ranges between 3.6% and 63.5% [7]. Although the clinical significance of the prevalence of ANA positivity in MS patients situation is not yet clear, some studies have stated that ANA positivity is associated with disease activity, while others have reported that ANA positivity will not have a clinical significance unless there are systemic symptoms indicating an underlying connective tissue disorder [11,12]. Different studies have reported the prevalence of anticardiolipin antibody (aCL) in MS patients of between 4.8% and 44%, and did not find any significant difference between MS patients and healthy controls in this regard.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance and prognostic value of serum autoantibody tests in multiple sclerosis

Oncel

Dalkılıç

Sayan

et al. 2024

Neurol Neurochir Pol.

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Introduction.It is known that multiple sclerosis (MS) often coexists with other autoimmune diseases. Hence, autoantibody (auto-Ab) tests may prove useful in the differential diagnosis of MS. The objectives of this study were to: (a) investigate the prevalence of auto-Ab positivity at the beginning of the MS diagnostic process; (b) assess whether Auto-Ab+ and Auto-Ab-patients differ in baseline clinical, laboratory, and radiological parameters; and (c) investigate the prognostic value during a two-year follow-up period.Material and methods. This retrospective study consisted of 450 patients aged between 18 and 55 years. All patients underwent a wide range of auto-Ab tests, anti-nuclear antibody (ANA) tests in particular. The expanded disability status scale (EDSS) scores of the patients were recorded at the time of diagnosis and at the end of a two-year follow-up period.Results. The mean age of the 212 patients, 148 (69.8%) female and 64 (30.2%) male, included in the study sample was 37 ± 10.83 years. The rate of relapsing cases was 84% (178). Oligoclonal band (OCB) was positive in 142 (86.6%) of the 164 tested cases. At least one of the auto-Ab tests was positive in 51 (24.1%) of the cases. ANA test was positive in 21 (9.9%) cases. There was no significant difference between patients with at least one positive auto-Ab test and without any positive auto-Ab test and between ANA-positive and ANA-negative patients in terms of age, gender, clinical features of MS, presence of brain stem lesion, presence of spinal lesion, OCB positivity, level of clinical improvement after the first pulse steroid treatment, family history, presence of comorbidity, presence of autoimmune disease, or EDSS scores recorded at the end of the two-year follow-up period (p > 0.05). Conclusions.Our study findings revealed that Auto-Ab positivity was more common in MS patients than in the general population. However, given their limited contribution to the diagnosis and differential diagnosis of MS with no effect on the prognostic process, auto-Ab tests should be requested only in the event of accompanying autoimmune disease symptoms, and in cases where the diagnosis of MS may be suspected.

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“…As part of the standard diagnostic process for multiple sclerosis, blood tests are frequently required. Routine autoantibody testing, however, is not always helpful for individuals who have a typical CIS [26]. As a result, it would be sensible to test for autoantibodies only in the presence of other symptoms that are indicative of other autoimmune illnesses.…”

Section: Diagnosismentioning

confidence: 99%

Review on Diagnosis and Management Approach of Multiple Sclerosis

Elssayed¹,

AlRgaiba²,

AlZalbani³

et al. 2023

Int J Pharm Res Allied Sci

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The most prevalent non-traumatic debilitating illness affecting young individuals is multiple sclerosis (MS) (2). Both industrialized and emerging nations are seeing an increase in the incidence and prevalence of MS, whose underlying etiology is still unknown. In addition to some well-known environmental variables, such as vitamin D or ultraviolet B light (UVB) exposure, Epstein-Barr virus (EBV) infection, obesity, and smoking, MS is a complicated illness with several genes that can influence disease vulnerability (3). The Medline, Pubmed, Embase, NCBI, and Cochrane databases were searched for studies of patients with non-alcoholic fatty liver disease. Incidence, etiology, and management options were analyzed. The etiopathogenesis of MS is convoluted. The processes through which genetic and environmental risk factors for the illness alter risk are still largely unclear, despite significant improvements in their detection. Discovering these processes might result in the identification of novel and more focused therapy targets as well as disease pathways.

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Should we systematically test patients with clinically isolated syndrome for auto-antibodies?

Abstract: Antinuclear-antibodies, anti-SSA and anti-SSB should not be routinely determined in CIS patients but only in those presenting symptoms suggestive of other ADs.

Cited by 11 publications

References 37 publications

Relevance of kappa free light chains index in patients with aquaporin‐4 or myelin‐oligodendrocyte‐glycoprotein antibodies

Relevance of kappa free light chains index in patients with aquaporin‐4 or myelin‐oligodendrocyte‐glycoprotein antibodies

Clinical significance and prognostic value of serum autoantibody tests in multiple sclerosis

Review on Diagnosis and Management Approach of Multiple Sclerosis

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