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

Mult Scler. 2015 Dec;21(14):1802-10. doi: 10.1177/1352458515575338. Epub 2015 Mar 16.

Abstract

Background: 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).

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Multiple sclerosis; antibodies; antinuclear; autoimmune diseases; demyelination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Antibodies, Antinuclear / blood*
  • Demyelinating Diseases / blood*
  • Female
  • Humans
  • Male
  • Sex Factors

Substances

  • Antibodies, Antinuclear
  • SS-A antibodies
  • SS-B antibodies