Abstract

BackgroundAntinuclear antibody (ANA) is a common test for excluding alternative diagnoses. However, the significance of ANA testing in patients with multiple sclerosis (MS) remains unclear.ObjectivesTo compare the prevalence of positive ANA antibody and its titer between patients with MS (cases) and non-MS patients who attended neurology clinics (control) in Saudi Arabia.MethodsA case-control review of ANA results for all patients who attended a neurology MS clinic. We compared a convenience sample of patients with MS with individuals with general neurology problems and no known autoimmune diseases.ResultsThere were 115 and 103 participants in the MS and control group, respectively. The mean age in the MS and control group was 33.76 ± 8.96 years and 34.95 ± 8.56 years, respectively. In the MS group, 25.22%, 60%, 11.30%, and 3.48% were negative, mildly positive, moderately positive, and strongly positive for ANA, respectively. In the control group, there were 34.95%, 54.37%, and 10.68% were negative, mild positive, and moderate positive, respectively. There were numerically, but not significantly, more positive cases in the MS group (74.78%) than in the control group (65.05%) (p = .117).ConclusionANA testing in routine MS screening for excluding alternative diagnoses should be discouraged unless there is a remarkable history or clinical examination finding. Mild positive ANA is common among patients with MS and does not significantly differ from the general population.

Highlights

  • Multiple sclerosis (MS) is one of the most common central nervous system autoimmune diseases

  • Antinuclear antibody (ANA) testing in routine multiple sclerosis (MS) screening for excluding alternative diagnoses should be discouraged unless there is a remarkable history or clinical examination finding

  • Mild positive ANA is common among patients with MS and does not significantly differ from the general population

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Summary

Introduction

Multiple sclerosis (MS) is one of the most common central nervous system autoimmune diseases. The term “no better explanation” is vague since there is no clear diagnostic test for excluding alternative diagnoses. There are plenty of potential alternatives that can act as a mimic for MS. There is no clear guideline for excluding alternative diagnoses, which is usually left to the judgment of the treating physician. Evidence for systemic autoimmune disease with respect to MS is usually searched to exclude possible alternative diagnoses, including systemic lupus erythematosus (SLE) and Alnajashi and Alshamrani The Egyptian Journal of Neurology, Psychiatry and Neurosurgery (2021) 57:27. Antinuclear antibody (ANA) is a common test for excluding alternative diagnoses. The significance of ANA testing in patients with multiple sclerosis (MS) remains unclear

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