Pediatric Multiple Sclerosis in the United Arab Emirates: Characteristics From a Multicenter Study and Global Comparison

Ismail, Fatima Y.; Gordon-Lipkin, Eliza; Huether, Katherine; Blair, Iain; Szólics, Miklós; Alsaadi, Taoufik; Aziz, Faisal; Suleiman, Jehan; Schiess, Nicoline

doi:10.1177/0883073818759103

Cited by 9 publications

(5 citation statements)

References 21 publications

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“…In the entire <18-year age population, the female:male ratio was 2.4:1; meanwhile, in the >12-year age group, it was 2.9:1, and in the ≤ 12-year age group, it was 1:1. This was in line with observations carried out in other countries, where similar ratios have been reported [6,21,23,24].…”

Section: Discussionsupporting

confidence: 93%

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The Clinical and Epidemiological Profile of Paediatric-Onset Multiple Sclerosis in Poland

Brola

Steinborn

Žák

et al. 2022

JCM

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Background. Paediatric-onset MS (POMS) has a unique clinical profile compared to the more prevalent adult-onset MS. For this study, we aimed to determine the demographic and clinical characteristics of POMS in Poland as well as addressing some of its epidemiological aspects. Methods. A retrospective study was conducted based on the Polish Multiple Sclerosis Registry, considering a population of children and adolescents with MS (age ≤ 18 years). Data were collected by all 13 centres across Poland specializing in diagnosing and treating POMS. The actual course of the disease and its clinical properties were compared between child (≤12 years) and juvenile (>12 years) patients. MS onset and its prevalence were assessed at the end of 2019, stratified by age range. Results. A total of 329 paediatric or juvenile patients (228 girls, 101 boys) with a clinically definite diagnosis of MS, in conformity with the 2017 McDonald Criteria, were enrolled. For 71 children (21.6%), the first symptoms appeared before the age of 12. The female: male ratio increased with age, amounting to 1:1 in the ≤12 years group and to 2.9:1 in the >12 years group. In most cases, the disease had multi-symptomatic onset (31.3%), and its course was mostly of a relapsing–remitting character (95.7%). The initial Expanded Disability Status Score for both groups was 1.63 ± 1.1, whereas the annual relapse rate was 0.84 during the first 2 years. The time between the onset of symptoms and diagnosis was longer in the younger patients (8.2 ± 4.2 vs. 4.6 ± 3.6 months; p < 0.005). On 31 December 2019, the age-adjusted prevalence standardized to the European standard population was 5.19/100,000 (95% CI, 4.64–5.78). Significantly higher prevalence was noted in the 13–18 years group (7.12; 95% CI, 6.64–7.86) than in the 9–12 years group (3.41; 95% CI, 2.98–3.86) and the <9 years group (0.56; 95% CI, 0.46–0.64; p < 0.001). Conclusion. POMS commencing at the age of ≤12 years is rare, differing significantly from the juvenile-onset and adult MS in terms of clinical characteristics, course, and incidence, as stratified by gender.

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Section: Discussionsupporting

confidence: 93%

“…In 2013 in Kuwait, Alroughani estimated the prevalence at 6.0 (4.2-8.5) [20]. A study in Abu Dhabi in a population <19 years of age showed a prevalence of 6.54 (4.00-10.6) [21]. The lowest prevalence, of 0.69 (0.58-0.80), was recorded in Japan [22].…”

Section: Discussionmentioning

confidence: 99%

The Clinical and Epidemiological Profile of Paediatric-Onset Multiple Sclerosis in Poland

Brola

Steinborn

Žák

et al. 2022

JCM

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“…Four studies provided Expanded Disability Status Scale scores for individual cases (n=168). 16,18,24,25 Of these cases, 5/168 (3.0%) children with pediatric-onset multiple sclerosis reached an Expanded Disability Status Scale score of 5.5 or higher during the various follow-up periods. Gudbjornsson et al 34 reported a median Expanded Disability Status Scale score of 0.0 (range 0.0-4.0) for 8 cases.…”

Section: Resultsmentioning

confidence: 99%

Epidemiology of Pediatric-Onset Multiple Sclerosis: A Systematic Review of the Literature

2019

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Multiple sclerosis onset in youth is increasingly recognized. A systematic review was conducted to assess incidence and prevalence of pediatric-onset multiple sclerosis, focusing on occurrence by age subgroups and disease course. A literature search for the period 1965-2018 was carried out, selecting population-based studies of multiple sclerosis in individuals aged 19 years and younger. Nineteen studies met inclusion criteria. One pediatric neurologist extracted the data. Overall incidence ranged from 0.05 (95% confidence interval 0.03-0.08) to 2.85 (95% confidence interval 2.83-2.86) per 100 000 children and overall prevalence from 0.69 (95% confidence interval 0.58-0.80) to 26.92 (95% confidence interval 26.61-27.23) per 100 000 children. Incidence increased with age. The female-male ratio increased from 1.2:1 in children <12 years old to 2.8:1 in children ≥12 years old. Ten studies (n=521 children) reported disease course. Seven studies found only relapsing-remitting disease and 3 studies found primary-progressive disease in 3.0% to 6.7%. Two secondary-progressive disease cases were identified. Epidemiologic data aid in understanding the magnitude of multiple sclerosis and its clinical phenotypes, for planning for new disease-modifying therapies in the pediatric population.

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“…There are other studies highlighting the increasing prevalence of MS in this region [7, 8]. There are also higher incidences reported in pediatric and adolescent age groups in the UAE [9].…”

Section: Introductionmentioning

confidence: 94%

Multiple Sclerosis in the Emirati Population: Onset Disease Characterization by MR Imaging

Ahmed

Mir

Shakra

et al. 2019

Multiple Sclerosis International

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Background and Objectives Multiple Sclerosis (MS) epidemiology is on the path of globalization mainly due to changing environmental factors. The prevalence of MS is on the rise in the Middle East and Persian Gulf region. Our observations has led us to hypothesize a heavy MRI lesion load at the onset of disease in a relatively younger native population. We aimed to estimate and characterize the onset disease on MRI using McDonald's criteria while applying its terms of “Dissemination in Space (DIS) and Dissemination in Time (DIT)”. Materials and Methods Retrospective review of onset MRI studies of 181 Emirati (native) individuals. Basic demographics were captured. Only 47 patients with Clinically Definite MS (CDMS) were included who had onset diagnostic MRI available. Lesion load was quantified using the specific zones of involvement designated for DIS: (1) Periventricular (PVZ) (I), (2) Juxta-cortical (II) (3) Infra-tentorial (III) and, (4) Spinal cord (IV). PVZ was sub-classified and lesions were quantified. A single enhancing lesion was required for DIT. Results Average age of onset was about 26 years with female dominance of about 2 : 1. About 50% had all 4 zones and about 85% had at least 3 zones involved at the onset. Involvement of only 1 zone was rare. Dissemination in time (DIT) in brain and/or cord was present in approximately 50%. Each of the 4 zones were involved in at least 70% of cases. PVZ was not spared in any case with at least 3 lesions present in approx. 95% and ≥12 lesions in approx. half of the patients. Spinal cord specifically cervical cord was involved in up to 80% with typical patchy lesions. Conclusion Onset disease characterization using MRI in a young Emirati cohort showed a heavy lesion load in the brain and spinal cord at the onset, signifying cumulative disease before presentation. Disseminated disease also facilitated early diagnosis of MS. The findings have significant potential ramifications for local environmental and cultural factors, as well as disease course and disability progression.

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Pediatric Multiple Sclerosis in the United Arab Emirates: Characteristics From a Multicenter Study and Global Comparison

Cited by 9 publications

References 21 publications

The Clinical and Epidemiological Profile of Paediatric-Onset Multiple Sclerosis in Poland

The Clinical and Epidemiological Profile of Paediatric-Onset Multiple Sclerosis in Poland

Epidemiology of Pediatric-Onset Multiple Sclerosis: A Systematic Review of the Literature

Multiple Sclerosis in the Emirati Population: Onset Disease Characterization by MR Imaging

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