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Autoimmune screening panel in patients with multiple sclerosis: A Vienna multiple sclerosis database study.

Fabian Föttinger1,2, Nik Krajnc1,2, Katharina Riedl1,2

  • 1Department of Neurology, Medical University of Vienna, Vienna, Austria.

European Journal of Neurology
|November 27, 2024
PubMed
Summary

Autoimmune screening panels (ASPs) show low seropositivity in multiple sclerosis (MS) patients, similar to the general population. Routine ASP use is not recommended unless systemic autoimmune disease is clinically suspected.

Keywords:
autoimmune diseasesdiagnostic techniques and proceduresdifferential diagnosismultiple sclerosisserology

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Area of Science:

  • Neurology
  • Immunology
  • Clinical Diagnostics

Background:

  • Autoimmune screening panels (ASPs) are frequently used in diagnosing multiple sclerosis (MS).
  • Limited data exist on the significance of ASP seropositivity in MS patients.
  • The utility of routine ASP implementation in MS diagnostics requires investigation.

Purpose of the Study:

  • To evaluate the viability of routine autoimmune screening panels (ASPs) in the diagnostic workup of multiple sclerosis (MS).
  • To determine the significance of ASP seropositivity in patients diagnosed with MS.

Main Methods:

  • Retrospective analysis of 212 patients diagnosed with MS between 2014-2021 from the Vienna Multiple Sclerosis Database.
  • Inclusion criteria required a confirmed MS diagnosis and performance of an ASP.
  • Analysis included patient demographics, presence of red flag symptoms, complement levels, and antibody subsets.

Main Results:

  • Only 5.6% of MS patients presented with red flag symptoms for systemic autoimmune disease.
  • Positive results on ASPs were infrequent, with antinuclear antibodies (ANAs) detected in 11.4% and extractable nuclear antibody subsets in 4.7%.
  • ASPs led to diagnoses of other autoimmune conditions in a small number of patients, with low positive predictive values (e.g., 4.9% for Sjögren syndrome).

Conclusions:

  • The rate of autoimmune screening panel seropositivity in multiple sclerosis patients is low.
  • ASP results in MS patients fall within the expected range for the general population.
  • Routine ASP testing is not warranted in MS diagnostics without specific clinical suspicion of systemic autoimmune disease.