Article

Multiple sclerosis in childhood: Clinical profile in 125 patients

Journal of Pediatrics (Impact Factor: 3.74). 10/1987; 111(3):359-63.
Source: PubMed

ABSTRACT Multiple sclerosis (MS) has its usual onset in early adult life (average age of 30 years), but age at clinical onset varies considerably. The implications of the age of onset on the clinical presentation and course of MS are unclear. This population-based retrospective study presents data from a group of 125 patients with onset of MS before age 16 years and can thus be considered as representative of MS occurring in childhood. It demonstrates that childhood MS is more frequent in girls, that it very often has a relapsing-remitting course, that initial bouts usually involve afferent structures of the central nervous system, that recovery from these is often complete, and that the pace of the disease is slow.

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    • "This is surprising, given the impact of puberty on gender bias in autoimmune diseases. For example, while pre-pubertal onset of MS is rare, with only 3–5% of cases reported in individuals under 18 years of age (Chitnis et al., 2009; Duquette et al., 1987; Ghezzi et al., 1997), gender bias within these cases of MS is absent (reviewed in (Chitnis, 2013)). Following the onset of puberty, however , incidence changes rapidly and pubertal girls are found to be at greater risk of developing MS than pre-pubertal girls (Ramagopalan et al., 2010). "
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    ABSTRACT: Autoimmune diseases are a range of diseases in which the immune response to self-antigens results in damage or dysfunction of tissues. Autoimmune diseases can be systemic or can affect specific organs or body systems. For most autoimmune diseases there is a clear sex difference in prevalence, whereby females are generally more frequently affected than males. In this review, we consider gender differences in systemic and organ-specific autoimmune diseases, and we summarize human data that outlines the prevalence of common autoimmune diseases specific to adult males and females in countries commonly surveyed. We discuss possible mechanisms for sex specific differences including gender differences in immune response and organ vulnerability, reproductive capacity including pregnancy, sex hormones, genetic predisposition, parental inheritance, and epigenetics. Evidence demonstrates that gender has a significant influence on the development of autoimmune disease. Thus, considerations of gender should be at the forefront of all studies that attempt to define mechanisms that underpin autoimmune disease.
    Frontiers in Neuroendocrinology 04/2014; 35(3). DOI:10.1016/j.yfrne.2014.04.004 · 7.58 Impact Factor
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    • "MS mainly affects individuals between the ages of 20 and 40 years, with a peak incidence at the age of 30 years. Population studies and case-control series show that between 1.7 and 5.6% of the MS population is younger than 18 years of age [1] [2] [6] [7] and that onset before 10 years of age occurs in less than 1% of all multiple sclerosis cases [2] [7]. The global incidence of pediatric MS is unknown, and the few epidemiological studies exhibit variable results. "
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    ABSTRACT: Multiple sclerosis (MS), a chronic inflammatory autoimmune disease of the central nervous system (CNS) commonly diagnosed in adults, is being recognized increasingly in children. An estimated 1.7%-5.6% of all patients with MS have clinical symptoms before reaching the age of 18 years. In comparison with adults, the diagnosis of MS in children can be more difficult, being dismissed or misdiagnosed as other clinical disorders. Although adults and children share basic aspects of the disorder, children have distinctive clinical features, neuroimaging, laboratory, and courses of the disease. The 2010 McDonald criteria have simplified the requirements for establishing the diagnosis of MS and have been proposed to be applicable for the diagnosis of pediatric MS, mainly in children 12 years and older. This paper describes the distinctive features of common pediatric demyelinating disorders, including MS, and summarizes the most recent advances based on the available literature.
    11/2013; 2013:673947. DOI:10.1155/2013/673947
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    • "Prognosis of the patients with low age of onset is one of the main questions in childhood and juvenile onset MS (early onset MS—EOMS). Some authors found a better prognosis for patients with low age of onset [2] [3] [5], other authors reported a more favorable prognosis for patients with higher age [9], and some of them could find no influence on the clinical features of age at onset [6]. Discussion about the existence of clinical courses different from that of adult onset MS (AOMS) is also still open. "
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    ABSTRACT: Objectives. In the present study, we aimed to compare the childhood and adult onset multiple sclerosis patients prospectively in their adulthood on the basis of clinical and magnetic resonance imaging (MRI) findings and cognitive impairment, which have not been performed before. Patients and Methods. Forty-six patients in whom the disease onset occurred before 16 years of age were included in the present study. Study subjects were compared with 64 randomly included adult onset patients. Results. Mean disease duration, clinical course, and female to male ratio did not differ in the groups. Cerebellar/brainstem and spinal involvement at onset were significantly higher in EOMS than in AOMS. Difference in MSFC between baseline and at the end of the 5th year was significantly worse in EOMS population (P = 0.02). The most significant difference was found in Paced Auditory Serial Addition Test (PASAT) (P = 0.008). Differences between baseline and at the end of the 5th year on the basis of T1 hypointense lesions were significantly higher in early onset MS than in adult onset MS patients (P = 0.02). Conclusions. Early onset MS seems to have worse prognosis than that of adult onset MS on the basis of clinical manifestation, cognitive impairment, and MRI parameters.
    11/2012; 2012(6):563989. DOI:10.1155/2012/563989
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