A comparative audit of anticardiolipin antibodies in oligoclonal band negative and positive multiple sclerosis

Abstract

It has been suggested that multiple sclerosis (MS) patients with positive anticardiolipin antibodies (ACLA) have some atypical features, including absent oligoclonal bands (OCB) in the cerebrospinal fluid (CSF). Our aim was to compare the frequencies of ACLA and related laboratory and clinical features in OCB negative (OCB-) and positive (OCB+) MS patients. We compared 41 OCB- patients attending a MS Clinic in a tertiary referral center, with 206 OCB+ patients. ACLA, anti-beta2-glycoprotein and other autoantibodies, lupus anticoagulant and coagulation markers were measured. We found a higher frequency of ACLA in OCB- patients, 18/41 versus 33/206 in OCB+ patients (P<0.0001). OCB- patients had more progressive MS than OCB+ subjects. There were no differences in age, sex, Expanded Disability Status Scale (EDSS) score, antiphospholipid syndrome symptoms between the groups. ACLA+ MS patients were more frequently in the OCB- group. Although this may suggest that they represent a special subgroup of MS, no other clinical or laboratory findings distinguish the groups. Although OCB- MS patients may be thought to be less active immunologically, this study shows they have more frequently ACLA than OCB+ patients. OCB- MS patients in our cohort do not appear to have a more benign form of MS, as has previously been suggested.

Autoantibodies and Sjogren’s Syndrome in Multiple Sclerosis, a Reappraisal

“…[4], [8], [12], [14], [15] It is possible that potential inclusion of NMO/NMOSD patients may have influenced these results. Our data is in agreement with studies [3]–[4], [6]–[7], [9], [10], [13], [22], [24] that have identified no association with clinical severity. Of note, two recent studies have suggested that MRI measurements of disease burden, including T2 lesion volume, may be associated with the presence of antiphospholipid autoantibodies in patients with MS. [5], [8] Further data is needed to confirm the significance of this finding.…”

No evidence of misdiagnosis in patients with multiple sclerosis and repeated positive anticardiolipin antibody testing based on magnetic resonance imaging and long term follow-up

“…A different pathogenesis, involving aCL Ab, was suggested for these patients, but this study has been criticised because patients were preselected regarding their atypical clinical manifestations. A recent study showed that MS patients without OCB in their CSF showed aCL Ab positivity more frequently than OCB positive patients 13. This is in line with our study, in which of four aCL Ab positive MS patients out of five tested for OCB, bands were absent in CSF.…”

Antiphospholipid Antibodies Overlapping in Isolated Neurological Syndrome and Multiple Sclerosis: Neurobiological Insights and Diagnostic Challenges

“…CNS APS and MS may be difficult to distinguish also from an immunological perspective, as the aPL antibody isotypes may involve IgG, IgM or IgA and therefore not always detected as the characteristic mirror pattern (positivity in serum and cerebrospinal fluid, CSF) or even of oligoclonal bands (OCB; predominant intrathecal antibody production; Cuadrado et al, 2000; Vilisaar et al, 2005). The two diseases resemble each other also for the epidemiological features of affected population, the relapsing-remitting course and for their appearance in neuroimaging (Figure 1).…”