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Pediatric-Onset Multiple Sclerosis: A Single Center Study
Erin Yamamoto1, Matthew Ginsberg2, Mary Rensel3
11 Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
Insights
Pediatric-onset multiple sclerosis (MS) is increasingly diagnosed in children. This study highlights environmental factors like obesity and vitamin D deficiency, and notes higher cortical lesion prevalence in pediatric MS patients.
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Pediatric-onset multiple sclerosis (POMS) is increasingly diagnosed, yet remains challenging to manage.
- Early diagnosis and intervention are crucial for improving long-term outcomes in children with MS.
Purpose of the Study:
- To retrospectively analyze the epidemiologic, clinical, neuroimaging, and therapeutic characteristics of a growing POMS patient cohort.
- To identify potential environmental triggers and assess treatment trends in pediatric MS.
Main Methods:
- Retrospective chart review of POMS patients over a 13-year period at a single center.
- Collection and analysis of data on demographics, clinical presentation, MRI findings, laboratory results, treatments, and outcomes.
Main Results:
- Identified associations between pediatric MS and environmental factors including obesity and vitamin D deficiency.
- Observed higher prevalence of cortical lesions and abnormal saccadic pursuit compared to existing literature.
- Documented a shift in therapeutic management towards second-line treatments over the study period.
Conclusions:
- Environmental factors like obesity and vitamin D deficiency may play a role in pediatric MS development.
- POMS presents with unique features, including a higher rate of cortical lesions and saccadic abnormalities.
- Treatment strategies for POMS are evolving, with increased use of second-line therapies.
Abstract:
Pediatric-onset multiple sclerosis (POMS), once thought to be rare, is now being diagnosed in increasing numbers in children. Despite improvements to diagnostic criteria, the diagnosis and management of POMS remains challenging. The aim of this study is to retrospectively describe a growing POMS patient population seen at a single center over a 13 year period. Epidemiologic, clinical, neuroimaging, laboratory features and therapeutic management and outcome data were collected and analyzed. These data support associations between MS and environmental triggers such as obesity and vitamin D deficiency. Presenting symptoms, magnetic resonance imaging and laboratory findings were consistent with the existing literature; however, the prevalence of cortical lesions and abnormal saccadic pursuit is higher than other reports. Data also demonstrate a shift in practice from first- to second-line therapies over the observed period.
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