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Pediatric multiple sclerosis and its familial recurrence: A population based study (1999-2017)
Sharareh Eskandarieh1, Mohammad Ali Sahraiain1, Negar Molazadeh1
1Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Pediatric onset multiple sclerosis (POMS) is increasingly prevalent, particularly in females, with a higher risk associated with maternal relatives. This study highlights POMS epidemiology in Tehran, showing a significant familial link.
Area of Science:
- Neurology
- Epidemiology
- Genetics
Background:
- Pediatric onset multiple sclerosis (POMS) accounts for 3-10% of all MS cases and is rising globally.
- POMS risk is influenced by a complex interplay of genetic and environmental factors during childhood and adolescence.
Purpose of the Study:
- To estimate the prevalence of POMS in Tehran.
- To assess the epidemiology of familial recurrence of POMS.
Main Methods:
- A retrospective, population-based, cross-sectional study was conducted from 1999 to 2017.
- Data from 1937 pediatric MS patients (≤18 years) were analyzed using Pearson's chi-square and logistic regression.
Main Results:
- The point prevalence of POMS in Tehran was 16.20 per 100,000 in 2017.
- Females represented 77.80% of cases, with the female-to-male ratio increasing with age (3.69:1 in 13-18 year olds).
- A positive familial history of MS was found in 14.9% of cases, with the strongest association in second-degree maternal relatives (OR=2.27).
Conclusions:
- Tehran exhibits a high prevalence of POMS compared to other large studies.
- POMS risk is higher in females, and this disparity widens post-puberty.
- A significant association exists between POMS and familial history, particularly in maternal second-degree relatives, warranting further investigation.
Background:
The Pediatric onset multiple sclerosis (POMS) prevalence is increasing worldwide accounting for around 3 to 10% of MS cases. The risk of POMS is supposed to reflect a complex interaction between environmental and genetic risk factors that may occur during the childhood, adolescent, or post-pubertal years.
Objective:
The present study aimed at estimating the prevalence of POMS and assessing the epidemiology of familial recurrence of POMS in Tehran.
Method:
A retrospective population based cross-sectional study was designed from 1999 to 2017. The baseline characteristic information was collected from MS patient's ≤18 years old (y/o). Pearson's chi-square test and logistic regression were used to analyze the relationship among variables and estimate the odds ratio (OR) via SPSS software, version 23.
Results:
A total of 1937 POMS patients (77.80% female and 22.20% male patients) participated in the study. The point prevalence of POMS was 16.20 per 100,000 populations in 2017. Mean age at disease onset was 15.96 ± 2.28 y/o. The female to male ratio was 2.02:1 in pre-pubertal cases (3-12 y/o), but it increased to 3.69:1 in 13-18 y/o age groups (P value = 0.001, OR = 1.82; 95% CI = 1.27-2.26). There were 288 (14.9%) cases with positive familial history of MS. The strongest association between MS risk and positive familial history was observed in second degree relatives who presented MS (P value = 0.046, OR = 1.74; 95%CI = 1.01-3.01). A significant association was observed among maternal second degree relatives with POMS (P value = 0.018, OR = 2.27; 95%CI = 1.15-4.47).
Conclusion:
In comparison to other large studies, the prevalence of POMS was high in the data collected from Tehran. POMS risk is higher among females and the sex ratio increases after puberty. We found a significant association between POMS risk and familial history in maternal second degree relatives. Further studies of POMS epidemiology might yield greater understanding of the natural history of this disease.
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