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Published on: December 9, 2015
Pediatric-onset multiple sclerosis in African-American black and European-origin white patients
Aaron L Boster1, Christina F Endress, Stephanie A Hreha
1Department of Neurology, The Ohio State University, Columbus, Ohio, USA.
Insights
Pediatric multiple sclerosis (MS) shows a more aggressive disease course in African-American children compared to European-origin children. African-American children experienced higher relapse rates, indicating a need for further research.
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Pediatric-onset multiple sclerosis (MS) is increasingly recognized.
- The relationship between ethnicity and pediatric MS disease characteristics is understudied.
Purpose of the Study:
- To investigate ethnic differences in the clinical presentation and disease course of pediatric-onset MS.
- To compare disease characteristics between African-American and European-origin children diagnosed with MS.
Main Methods:
- Retrospective review of 46 patients with pediatric-onset MS at a major teaching facility.
- Comparison of demographic and clinical data between African-American (n=24) and European-origin (n=19) patients.
- Analysis included age at onset, follow-up duration, time to disease-modifying therapy, sex distribution, and annualized relapse rate.
Main Results:
- No significant differences in mean age at onset or follow-up duration between ethnic groups.
- A significantly higher percentage of females in the African-American group (83%) compared to the European-origin group (47%).
- The annualized relapse rate was significantly higher in African-American children (1.80) versus European-origin children (1.13).
Conclusions:
- Findings suggest a more aggressive disease phenotype in African-American children with pediatric-onset MS.
- Results align with observations in adult-onset MS, indicating a potential pattern across age groups.
- Larger multicenter studies are recommended to validate these ethnic-based findings in pediatric MS.
Abstract:
Pediatric-onset multiple sclerosis is now recognized, but the association with ethnicity has not been well studied. In a retrospective review at a major teaching facility, 46 pediatric-onset multiple sclerosis patients were identified; of these, 24 were African-American black and 19 were European-origin white. Both groups were similar in mean age at onset (black, 13.6 +/- 3.36 years; white, 13.68 +/- 3.42 years) and total duration of follow-up (black, 42.7 +/- 43.5 months; white, 38.2 +/- 35.3 months), with no significant difference in time to onset of disease-modifying therapy (black, 11.2 +/- 4.7 months; white, 12.4 +/- 5.1 months). The percentage of females was higher in the black than in the white group (83% vs 47%; P = 0.014). The annualized relapse rate was significantly higher in the black than in the white group (1.80 +/- 1.14 vs 1.13 +/- 0.50; P < 0.001). These findings are consistent with data suggesting a more aggressive disease phenotype among African-American blacks with adult-onset multiple sclerosis. Larger multicenter studies are warranted to confirm the findings.
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