Rheumatologic profile in CNS demyelinating disorders

Abstract

Background & Objectives: Multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) are central demyelinating disorders that have an autoimmune inflammatory etiology. The aim of the present study is to assess the frequency of seropositivity for autoantibodies and other rheumatologic serum markers in patients with CNS demyelinating diseases and to determine whether the seropositivity for autoantibodies differs between MS, anti-AQP4 positive and anti-AQP4 negative NMOSD, and MOGAD within Indian population in Rajasthan.

Methods: This is an analytical cross-sectional study that included all consecutive patients presenting with CNS demyelinating diseases during the period June 2021 to June 2023. The following information was collected from the patient: demographics; clinical syndrome of presentation, serum aquaporin-4 antibody, serum MOG antibody and CSF oligoclonal bands. Rheumatological profile including antinuclear antibody (ANA), rheumatoid factor (RF) antibodies, anti-dsDNA, erythrocyte sedimentation rate (ESR), C reactive protein (CRP) and anti neutrophil cytoplasmic antibody tests (both p & c ANCA) was investigated. Demographic and clinical characteristics were described in terms of absolute and relative frequencies. Rheumatologic profiles was compared across these diseases.

Results: ANA and Anti dsDNA was significantly higher in NMOSD as compared to MS and MOGAD patients. Similarly, an insignificant increase in frequency of seropositivity for CRP, RA factor and ESR was noted in NMOSD.

Conclusion: Serum rheumatologic markers such as ANA, Anti dsDNA, ESR, CRP and RA factor are related to CNS demyelination. Further studies may be needed to determine the long term significance of these markers.