Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, Western Australia, Australia.
J Clin Neurosci. 2010 Aug;17(8):1009-13. doi: 10.1016/j.jocn.2009.12.011. Epub 2010 May 23.
We aimed to characterize the clinical profile and human leukocyte antigen (HLA)-DRB1 genotype of patients with late onset multiple sclerosis (LOMS) in Western Australia. The clinical features, laboratory studies and HLA-DRB1 alleles were analysed in patients with multiple sclerosis (MS) with onset over 50years of age and compared with 100 patients with early onset MS (EOMS). Of a cohort of 829 patients with MS, 73 (8.8%) presented at over 50years of age, including 14 (1.7%) over 60years. Patients with LOMS had a lower female to male ratio, more frequent initial motor dysfunction, less frequent sensory symptoms and optic neuritis, a more frequent primary-progressive course and shorter time to reach Extended Disability Status Scale (EDSS) scores of 3.0 and 6.0. More LOMS patients were initially misdiagnosed compared to patients with EOMS. HLA-DRB1 *1501 was strongly associated with both LOMS and EOMS compared to the Control subjects, while HLA-DRB1 *0801 was over-represented in patients with LOMS. We concluded that patients with LOMS have a different clinical profile when compared to those with EOMS. Carriers of HLA-DRB1 *0801 may be more prone to develop MS at a later age.
我们旨在描述澳大利亚西部迟发性多发性硬化症（LOMS）患者的临床特征和人类白细胞抗原（HLA）-DRB1 基因型。对发病年龄超过 50 岁的多发性硬化症（MS）患者进行临床特征、实验室研究和 HLA-DRB1 等位基因分析，并与 100 例早发性 MS（EOMS）患者进行比较。在 829 例 MS 患者中，73 例（8.8%）年龄超过 50 岁，其中 14 例（1.7%）年龄超过 60 岁。LOMS 患者的男女比例较低，初始运动功能障碍更常见，感觉症状和视神经炎较少见，原发性进行性病程更常见，达到扩展残疾状态量表（EDSS）评分 3.0 和 6.0 的时间更短。与 EOMS 患者相比，更多的 LOMS 患者最初被误诊。与对照组相比，HLA-DRB11501 与 LOMS 和 EOMS 均强烈相关，而 HLA-DRB10801 在 LOMS 患者中过度表达。我们得出结论，与 EOMS 患者相比，LOMS 患者的临床特征不同。携带 HLA-DRB1*0801 的患者可能更容易在较晚的年龄患上 MS。
