SYSTEMIC AUTOIMMUNE FEATURES AND MULTIPLE-SCLEROSIS - A 5-YEAR FOLLOW-UP-STUDY

Objectives: To evaluate in patients with multiple sclerosis (MS) the o ccurrence of clinical systemic signs and biological autoimmune abnorma lities, including positive titers of antinuclear antibodies and antiph ospholipid antibodies, suggestive of autoimmune diseases that may affe ct the central nervous system. Also, to compare the clinical and magne tic resonance imaging features and evolution of MS in patients with an d without autoimmune abnormalities. Design and Patients: Prospective s tudy of 161 patients fulfilling the criteria of having probable or def inite MS hospitalized in our institution between November 1990 and Jun e 1992. Results: Among the 161 patients, 84 (52.1%) had at least 1 cli nical and/or biological general sign suggestive of an autoimmune disea se; 64 were followed up for 4 to 5 years. The diagnosis of MS was conf irmed in 50 patients and is still pending in 14 of them. No significan t difference was found between patients with MS who were free of autoi mmune features and those with autoimmune abnormalities (MS plus) conce rning the age of disease onset, the presenting symptoms and signs, sym ptoms found on neurologic examination, and the course of the disease. For all patients with confirmed MS, general signs were found in 13.3%, positive titers of antinuclear antibodies in 26%, and positive titers of antiphospholipid antibodies in 6.2%. Conclusions: Patients with MS with autoimmune features, including those with titers of antinuclear antibodies of 1:100 or less and/or antiphospholipid antibodies, are no t different than others with MS, and therefore should not be excluded from clinical trials.