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Younger children with MS have a distinct CSF inflammatory profile at disease onset

D Chabas1, J Ness, A Belman

  • 1UCSF Regional Pediatric MS Center, 350 Parnassus Ave., Suite 908, San Francisco, CA 94117, USA. dchabas@gmail.com

Neurology
|February 4, 2010
PubMed

Insights

Pediatric multiple sclerosis (MS) shows distinct cerebrospinal fluid (CSF) inflammatory profiles based on age at onset. Earlier-onset MS may involve innate immune system activation, potentially delaying diagnosis.

Area of Science:

  • Neurology
  • Immunology
  • Pediatrics

Background:

  • Pediatric multiple sclerosis (MS) presents differently based on age, but the impact of age on cerebrospinal fluid (CSF) inflammation is not well understood.
  • Age-related differences in CSF profiles may contribute to diagnostic delays in pediatric MS.

Purpose of the Study:

  • To compare the CSF cellular and immunoglobulin G (IgG) profiles between earlier- and later-onset pediatric MS patients.
  • Investigate how age influences the inflammatory markers in pediatric MS.

Main Methods:

  • An observational study analyzed CSF data from 6 pediatric MS centers.
  • Compared CSF white blood cell (WBC) differential counts, IgG index, and IgG oligoclonal bands in earlier-onset (<11 years) versus later-onset (≥11 to <18 years) pediatric MS patients within 3 months of presentation.

Main Results:

  • Identified 40 earlier-onset and 67 later-onset pediatric MS patients.
  • Earlier-onset patients had a lower proportion of lymphocytes and a higher proportion of neutrophils in CSF compared to later-onset patients.
  • Fewer earlier-onset patients exhibited an elevated IgG index (35%) compared to later-onset patients (68%).

Conclusions:

  • Age significantly modifies the CSF inflammatory profile at the onset of pediatric MS.
  • Findings suggest innate immune system activation or an immature immune response in earlier-onset pediatric MS.
  • These age-related CSF differences may complicate and delay the diagnosis of pediatric MS.
Abstract

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