Polyautoimmunity in Multiple Sclerosis: One Study Finds a Lower Prevalence and Sex Parity
There are very few scientific studies on Multiple autoimmune syndrome. Of those I’ve found, Multiple sclerosis has only been researched in one other study. There could be a number of reasons that this is the case. Most of the studies on Multiple autoimmune syndrome have been conducted through the discipline of rheumatology, and Multiple sclerosis is an autoimmune disease managed through a different specialty: neurology. This is yet another example of the fracturing of autoimmune disease research by body system, which may create helpful boundaries for research, but erects barriers to a comprehensive understanding of autoimmune disease.
Polyautoimmunity in a Greek cohort of multiple sclerosis is unique in its size, focus and timeframe, with 2,140 participants with Multiple sclerosis studied in the context of polyautoimmunity and Multiple autoimmune syndrome over eleven years. Its findings are interesting, too: a lower prevalence of polyautoimmunity—just 8%—in Multiple sclerosis, the lowest of any of the other autoimmune diseases I’ve written about. And unlike the other studies I’ve written about, this study did not find that female sex was associated with polyautoimmunity—it was just as prevalent in men with Multiple sclerosis as women with Multiple sclerosis. The detailed results are reviewed below, including a comparison with the results of one other study that researched the prevalence of polyautoimmunity in Multiple sclerosis.
Area of Investigation
Multiple Autoimmune Syndrome: when one person meets the study classification criteria for three or more autoimmune diseases.
Study Titles
Polyautoimmunity in a Greek cohort of multiple sclerosis
Introducing polyautoimmunity: secondary autoimmune diseases no longer exist
Results
Polyautoimmunity in a Greek cohort of multiple sclerosis
Between January of 2000 and January of 2011, a group of 2,140 participants with Multiple sclerosis and a control group of 1,580 participants was studied for polyautoimmunity, a condition where study participants meet the study classification criteria for two or more autoimmune diseases. The control group was matched for age and gender with the Multiple sclerosis group.
179 (8.36%) participants had polyautoimmunity. Of 179 participants with polyautoimmunity, 21 had Multiple autoimmune syndrome. 96 (6.07%) participants in the control group had an autoimmune disease (not Multiple sclerosis). None of the participants in the control group had more than one autoimmune disease.
The most common autoimmune diseases for participants with Multiple sclerosis and polyautoimmunity were Autoimmune thyroid disease (58.2%), psoriasis(10.8%), Vitiligo (6.3%), Type 1 diabetes (5.1%), and inflammatory bowel disease (3.8%). The prevalence of Autoimmune thyroid disease and Vitiligo accounted for the main difference between the incidence of autoimmune diseases in participants with Multiple sclerosis compared to participants in the control group.
Women (8.6%) and men (8%) showed no statistical difference in rates of polyautoimmunity. The rates of Multiple autoimmune syndrome among women (0.8%) and men (1.3%) also showed no statistically significant difference. Not surprisingly, women showed a higher incidence of Autoimmune thyroid disease, whereas men had higher rates of iris (eye) inflammation and ankylosing spondylitis.
Participants with Multiple autoimmune syndrome had higher rates of Vitiligo, iris (eye) inflammation, and Rheumatoid arthritis, compared to patients with Multiple sclerosis and one other autoimmune disease. 7.4% of participants were diagnosed with Multiple sclerosis and another autoimmune disease in the same year. 42% of participants were diagnosed with Multiple sclerosis at least one year prior to their diagnosis of another autoimmune disease. 50.6% were diagnosed with an autoimmune disease at least one year prior to their diagnosis of Multiple sclerosis.
Introducing polyautoimmunity: secondary autoimmune diseases no longer exist.
154 participants with Multiple sclerosis were included in this study. 13.6% had polyautoimmunity: 9.1% had co-occurring Autoimmune thyroid disease; 2.6% had co-occurring Sjogren’s syndrome.
Why it Matters
Understanding the prevalence rates of polyautoimmunity in Multiple sclerosis is important for assessing risk of new symptoms, and patient approaches to health practitioners in the search for prompt work up and treatment. In the context of this study, it’s also critical for men to understand their equal risk for polyautoimmunity with Multiple sclerosis, even if it’s lower than with other autoimmune disease, so they can advocate for the care they need when new autoimmune disease symptoms arise.
Study Type
Polyautoimmunity in a Greek cohort of multiple sclerosis is an observational retrospective study of 2,140 participants with Multiple sclerosis, published in 2015. Due to sample size and study type, the results of this study should be given more weight than the study below.
Introducing polyautoimmunity: secondary autoimmune diseases no longer exist is an observational cross-sectional study that I review in greater depth here.
For reference, I have ranked medical study types in order of least likely to be affected by hidden bias to most likely to be affected. Those studies that are most likely to be affected by hidden bias should be taken seriously, but not given the same weight as studies that are less likely to be affected by hidden bias. Polyautoimmunity in a Greek cohort’s…structure appears in bold.
Clinical Trial
Observational Study
Prospective
Retrospective
Cross-sectional
References
G. Deretzi, J. Kountouras, S. A. Polyzos, E. Koutlas, S.-H. Pelidou, G. Xeromerisiou, C. Zavos, I. Tsiptsios. Polyautoimmunity in a Greek cohort of multiple sclerosis. Acta Neurologica Scandinavica. 2015 April: 131: 225–230. https://doi.org/10.1111/ane.12308
Rojas-Villarraga A, Amaya-Amaya J, Rodriguez-Rodriguez A, Mantilla RD, Anaya JM. Introducing polyautoimmunity: secondary autoimmune diseases no longer exist. Autoimmune Dis. 2012;2012:254319. doi: 10.1155/2012/254319. Epub 2012 Feb 20. PMID: 22454759; PMCID: PMC3290803.