Evaluation of autoantibody positive in multiple sclerosis patients

Objective: Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system in which impaired immune activation is involved. It is known that other autoimmune diseases are seen more frequently in MS patients.  Many rheumatologic diseases could cause neurologic disorders that mimic MS.  Our aim in this study is to determine the rates of autoantibody positivity and the clinical significance of these positivity rates in patients with MS.

Method: 110 patients who were followed up with MS diagnosis in our clinic between 2008 and 2018  were retrospectively evaluated for autoimmune disease biomarkers. The diagnosis of MS was confirmed using both 2005 and 2010 Revised Mc Donald Criteria.

Results: The ANA (antinuclear antibody) positivity rate in our patients was 10.9%,  the ANA profile positivity was 9.1%. Anti-ds DNA (double stranded deoxyribonucleic acid) positivity rate was 1.8%, anti-cardiolipin Ig (immunglobulin) G and Ig M were 0.9% positive. Anti-microsomal antibody positivity was 11.8% while anti-thyroglobulin antibody was positively 13.6%. The value of complement 3 (C3) was found to be 92.7% normal and 4.5% higher and 2.7% lower, respectively. The C4 values ​​were 98.2% normal, while they were 11.8% higher than normal .

Six patients had six different diseases  in which ethiopathogenesis the role of autoimmunity was also revealed ( ankylosing spondylitis, psoriasis, systemic lupus erythematosus, morfea, ptriyazis, Sjögren's syndrome). 

Conclusions: Although some autoantibody positivities in MS patients are more frequent than healthy controls, these positivities are not usually associated with systemic rheumatologic disease and haven’t clinical significance. Therefore, the evaluation of autoantibodies in each MS patient does not seem cost effective. So, the MS patients whose autoantibody levels are to be measured should be well selected before the evaluation the patients' medical history and complaints should be taken into consideration.

Sonuç: MS hastalarında otoantikor pozitifliklerinin bazıları topluma göre daha sık olsa da çoğunlukla bu otoantikor pozitiflikleri sistemik romatolojik hastalık varlığı ile ilişkili değildir ve klinik açıdan anlam içermemektedir. Bu nedenle her MS hastasında otoantikorların araştırılması maliyet açısından etkin görünmemektedir. Bu yüzden otoantikor düzeyi ölçülecek MS hastaları iyi seçilmeli ve ölçüm öncesinde hastaların öykü ve yakınmaları dikkate alınmalıdır.