Hypogammaglobulinemia: A contributing factor to multiple sclerosis fatigue?

Area of Science:

• Neurology
• Immunology
• Autoimmune Diseases

Background:

• Fatigue is a primary disabling symptom in multiple sclerosis (MS).
• Approximately 8-25% of people with MS (PwMS) experience hypogammaglobulinemia, a deficiency in immunoglobulin G (IgG).

Purpose of the Study:

• To investigate the association between fatigue and IgG hypogammaglobulinemia in PwMS.
• To explore potential therapeutic implications of this association.

Main Methods:

• Retrospective analysis of 134 PwMS from Eginition University Hospital Athens and University Hospital Bern.
• Statistical analysis included Mann Whitney U-test, ANOVA, Chi-squared test, and multivariable linear regression.

Main Results:

• 72.4% of PwMS reported fatigue.
• Lower IgG serum concentration, daytime sleepiness, and depressive mood were significantly associated with fatigue.
• The association between IgG serum concentration and fatigue remained significant even in PwMS without depressive symptoms or daytime sleepiness.

Conclusions:

• An association exists between IgG hypogammaglobulinemia and fatigue in PwMS.
• This finding may extend to other autoimmune diseases.
• Prospective validation could support IgG supplementation as a therapeutic strategy for MS-fatigue.