A characteristic feature of immunologic diseases is their association with each other. For multiple sclerosis (MS), several retrospective studies reported increased as well as expected coincidence rates with other immunologic diseases. We conducted a prospective case-control study of MS patients and healthy volunteers and found 13/101 MS patients and 2/97 controls with such diseases (P = 0.009, chi-square test), as well as 47/88 MS patients versus 31/95 controls with a variety of circulating autoantibodies (P = 0.004, chi-square test). These results speak for an increased coincidence of MS with other immunologic diseases and support Presented in part to the 103. Wandervers. sudwestd. Neurol.
In 31 patients with multiple sclerosis (MS) the endocrine functions of the hypothalamus, the pituitary and several peripheral endocrine glands were assessed with a combined pituitary test; 3/31 patients had an endocrine disease: one primary hypothyroidism, one primary amenorrhea and one primary male hypogonadism. We found no patient with endocrine disease of the hypothalamus, the pituitary or the adrenals. However, the poststimulatory secretion of cortisol, growth hormone or thyroid-stimulating hormone was impaired in 7/31 patients, suggesting a possible preclinical 1 endocrine insufficiency in these patients.When clinical improvement of multiple sclerosis (MS) with ACTH therapy became apparent (1,2), the question arose, whether this indicated a defect of the adrenal and/or pituitary. Measurements of cortisol and corticosteroid metabolites in urine and later in plasma showed conflicting results with normal values in some reports, yet elevated basal or depressed stimulatory values in others (3-13). The abnormal values were hypothetically related to MSinduced stress, to MS lesions in the hypothalamus, to an insufficiency of the pituitary, or to an adrenal disturbance associated with MS. Other anterior pituitary hormones also showed unexplained abnormal values in some MS patients (12, 14-16). Manifest endocrine diseases of these organs were not identfied. In fact, there are only singular reports on the coincidence of MS and such diseases (17-21).Because of the unresolved abnormal endocrine findings, we evaluated MS patients with a combined pituitary test, by which the interactions between hypothalamus, pituitary and several endocrine endorgans including the adrenals can be determined. Patients and methodsOf 101 consecutively admitted patients with clinically definite or probable MS (65 f, 36 m) 3 1 patients (16 f, 15 m) participated after thorough information and written consent. 46 patients were excluded because of medical or ethical reasons, 24 patients refused. The 3 1 patients were 20-58 years old (median 42 yrs), the disease duration was 1-21 years (median 7 yrs), the total disability score (22) was 0-2 in 18 patients, 3-5 in 7 patients, and 6-7 in 6 patients. The MS course was relapsing-remitting in 16 patients, relapsing-remitting/progressive in 10 and pri-
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.