Niederwieser Gerald, Buchinger Wolfgang, Bonelli Raphael M, Berghold Andrea, Reisecker Franz, Költringer Peter, Archelos Juan J
Department of Neurology, Barmherzige Brüder Hospital, Bergstrasse 27, 8021 Graz, Austria.
J Neurol. 2003 Jun;250(6):672-5. doi: 10.1007/s00415-003-1053-9.
Since multiple sclerosis (MS) and autoimmune thyroiditis (AIT) are presumed to be of autoimmune origin the correlation of these two diseases is of special interest. The aim of this study was to determine whether there are differences in the prevalence of thyroid disease with special emphasis on AIT compared with MS and normal subjects and whether the presence of thyroid disease correlates with disability, disease course, age, and disease duration. 353 consecutive patients with clinically definite MS, without interferon-beta treatment and 308 patients with low back pain or headache were extensively examined for the presence of non-immune or autoimmune thyroid disease. We found a significantly higher prevalence of AIT in male MS patients (9.4 %) than in male controls (1.9 %; p = 0.03). The prevalence of AIT in female MS patients (8.7 %) did not differ from female controls (9.2 %). Hypothyroidism, caused by AIT in almost all cases, showed a tendency to be more severe and more often present in patients with MS. There was no association between relapsing-remitting and secondary progressive disease course of MS and the prevalence of AIT. MS patients with AIT were significantly older but did not differ in disease duration and expanded disability status scale (EDSS). Further studies are warranted, to see if there is a difference in sex-hormone levels between MS patients with and without AIT and healthy controls. Longitudinal studies comparing MS patients with or without AIT could show whether there is an influence of AIT on the disease course or progression.
由于多发性硬化症(MS)和自身免疫性甲状腺炎(AIT)被认为是自身免疫性起源,这两种疾病之间的相关性备受关注。本研究的目的是确定与MS患者和正常受试者相比,甲状腺疾病(尤其着重于AIT)的患病率是否存在差异,以及甲状腺疾病的存在是否与残疾、病程、年龄和疾病持续时间相关。对353例未经β-干扰素治疗的临床确诊MS患者以及308例腰痛或头痛患者进行了广泛检查,以确定是否存在非免疫性或自身免疫性甲状腺疾病。我们发现男性MS患者中AIT的患病率(9.4%)显著高于男性对照组(1.9%;p = 0.03)。女性MS患者中AIT的患病率(8.7%)与女性对照组(9.2%)无差异。几乎所有病例中由AIT引起的甲状腺功能减退在MS患者中往往更严重且更常见。MS的复发缓解型和继发进展型病程与AIT的患病率之间无关联。患有AIT的MS患者年龄显著更大,但在疾病持续时间和扩展残疾状态量表(EDSS)方面无差异。有必要进一步研究,以观察患有和未患有AIT的MS患者与健康对照之间性激素水平是否存在差异。比较患有或未患有AIT的MS患者的纵向研究可以表明AIT是否对疾病病程或进展有影响。