DECREASED VITAMIN-B(12) AND FOLATE LEVELS IN CEREBROSPINAL-FLUID AND SERUM OF MULTIPLE-SCLEROSIS PATIENTS AFTER HIGH-DOSE INTRAVENOUS METHYLPREDNISOLONE

Twenty-one patients (15 women, 6 men) with definite multiple sclerosis (MS) were treated with 1000 mg intravenous methylprednisolone-succina te (MP) daily for 10 days. Before MP treatment there was a negative co rrelation (r = 0.59, P = 0.0084) between serum vitamin B-12 and progre ssion rate, defined as the ratio of the score on Kurtzke's Expanded Di sability Status Scale and disease duration. A significant decrease was demonstrated in the cerebrospinal fluid (CSF) and serum levels of fol ate and in the CSF level of vitamin B-12 after MP treatment. The decre ase in serum B-12 was not statistically significant. After MP treatmen t all median levels of vitamin B-12 and folate were below the referenc e medians. We hypothesize that low or reduced vitamin B-12/folate leve ls found in MS patients may be related to previous corticosteroid trea tments. Otherwise a more causal relationship between low vitamin B-12/ folate and MS cannot be excluded. Further studies may be required to c larify the vitamin B-12 and folate metabolism in patients with MS.