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

Multiple Sclerosis : Clinical and Laboratory Research
Laura NegrottoXavier Montalban

Abstract

Several autoimmune diseases (ADs) can mimic multiple sclerosis (MS). For this reason, testing for auto-antibodies (auto-Abs) is often included in the diagnostic work-up of patients with a clinically isolated syndrome (CIS). The purpose was to study how useful it was to systematically determine antinuclear-antibodies, anti-SSA and anti-SSB in a non-selected cohort of CIS patients, regarding the identification of other ADs that could represent an alternative diagnosis. From a prospective CIS cohort, we selected 772 patients in which auto-Ab levels were tested within the first year from CIS. Baseline characteristics of auto-Ab positive and negative patients were compared. A retrospective revision of clinical records was then performed in the auto-Ab positive patients to identify those who developed ADs during follow-up. One or more auto-Ab were present in 29.4% of patients. Only 1.8% of patients developed other ADs during a mean follow-up of 6.6 years. In none of these cases the concurrent AD was considered the cause of the CIS. In all cases the diagnosis of the AD resulted from the development of signs and/or symptoms suggestive of each disease. Antinuclear-antibodies, anti-SSA and anti-SSB should not be routinely determined in C...Continue Reading

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Citations

Oct 10, 2018·Current Opinion in Neurology·Jiwon OhXavier Montalban
Sep 15, 2018·Der Nervenarzt·C Trebst, T Kümpfel
Dec 2, 2020·Journal of Clinical Medicine·Josip SremecNataša Kovačić

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Methods Mentioned

BETA
enzyme-linked immunosorbent assay

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