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Intrathecal IgM synthesis is a prognostic factor in multiple sclerosis.
Luisa M Villar1, Jaime Masjuan, Pedro González-Porqué
1Department of Immunology, Hospital Ramón y Cajal, Madrid, Spain. lvillar.hrc@salud.madrid.org
Annals of Neurology
|January 31, 2003
Summary
Intrathecal IgM synthesis (ITMS) indicates a worse prognosis in multiple sclerosis (MS) patients. Longer follow-up confirmed ITMS is linked to faster disease progression and higher disability.
Area of Science:
- Neurology
- Immunology
Background:
- Intrathecal IgM synthesis (ITMS) is associated with poorer outcomes in early multiple sclerosis (MS).
- Longitudinal data are needed to confirm ITMS as a prognostic marker in MS.
Purpose of the Study:
- To evaluate if ITMS predicts a poor long-term prognosis in relapsing-remitting MS patients.
- To assess the relationship between ITMS and disease progression over an extended follow-up period.
Main Methods:
- Oligoclonal IgM bands were analyzed in 29 MS patients.
- Patients were followed for 5 to 16 years.
- Outcomes included time to secondary-progressive MS (SPMS), time to Expanded Disability Status Scale (EDSS) 6, and benign MS prevalence.
Main Results:
- 70.8% of patients with ITMS converted to SPMS versus 0% without ITMS.
- 63.6% of patients with ITMS reached EDSS 6, compared to 0% above EDSS 3 without ITMS.
- 82% of patients with benign MS lacked ITMS, while all with non-benign MS had ITMS.
Conclusions:
- ITMS is an unfavorable prognostic marker in MS.
- Presence of oligoclonal IgM bands in CSF predicts faster disease progression and increased disability.
- ITMS is a significant indicator of non-benign MS evolution.