Abstract

Introduction and Aim: Multiple sclerosis is a demyelinating autoimmune disease of the central nervous system. ANA, anti-dsDNA, and ENA profiles have been used in the diagnosis and treatment of autoimmune diseases. Low vitamin D and B12, and folate levels, and high homocysteine levels are often detected in autoimmune diseases. In the present study, we aimed to investigate these parameters in patients with Multiple sclerosis and Multiple sclerosis like disease, as diagnosed in accordance with the revised McDonald criteria. Methods: The laboratory results of 161 (53Multiple sclerosis, 108 Multiple sclerosis like) patients who were examined for the differential diagnosis of vasculitis/Multiple sclerosis in the last 14 months were evaluated in this present retrospective, cross-sectional study. ANA, anti-dsDNA, ENA profile, vitamin D and B12, folic acid, and homocysteine levels were recorded. Results: ANA levels in 12 patients with Multiple sclerosis and in 34 patients with Multiple sclerosis like disease were positive; however, ANA levels were negative in 37 patients Multiple sclerosis, and 72 patients with Multiple sclerosis like disease. Anti-dsDNA levels in 4 patients Multiple sclerosis and in 23 with Multiple sclerosis like disease were positive; however, they were negative in 44 patients with Multiple sclerosis and 81 with Multiple sclerosis like disease. The mean vitamin B12 and D, and folate levels of 111 patients were found below the lower normal limit, whereas PTH and homocysteine levels were found over the upper normal limit. Conclusion: The present study was the first to report the autoimmune parameters and vitamin D levels in patients with Multiple sclerosis and Multiple sclerosis like disease in Bolu province in the Western Black Sea region. Although ANA positivity comes to the forefront in the diagnosis of autoimmune diseases, high anti-dsDNA positivity in patients with MS-like disease suggests different underlying mechanisms. In the present study, vitamin D and B12, and folic acid levels were detected at the lower limit of normal, and homocysteine levels were found at the upper limit of normal. Prospective studies including a control group, in addition to retrospective studies are required to elucidate the roles of autoantibodies and vitamins in the pathogenesis Multiple sclerosis.

Highlights

  • Introduction and AimMultiple sclerosis is a demyelinating autoimmune disease of the central nervous system

  • The mean vitamin B12 and D, and folate levels of 111 patients were found below the lower normal limit, whereas PTH and homocysteine levels were found over the upper normal limit

  • anti-nuclear antibody (ANA) positivity comes to the forefront in the diagnosis of autoimmune diseases, high anti-dsDNA positivity in patients with Multiple sclerosis (MS)-like disease suggests different underlying mechanisms

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Summary

Introduction

Multiple sclerosis is a demyelinating autoimmune disease of the central nervous system. ANA, anti-dsDNA, and ENA profiles have been used in the diagnosis and treatment of autoimmune diseases. Low vitamin D and B12, and folate levels, and high homocysteine levels are often detected in autoimmune diseases. Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS) that is associated with relapse and remissions. The monitoring and replacement of deficient levels of ANA, vitamin D, and folate are important for the course of autoimmune diseases such as multiple sclerosis. The confirmatory tests are the extractable nuclear antigen (ENA) and anti-dsDNA tests, which are studied as an enzyme-linked immunosorbent assay (ELISA) in routine laboratories after the detection of ANA positivity. The monitoring of vitamin levels together with these tests are important

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