Department of Clinical Neuroscience, Institute of Neuscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Neurology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Brain Behav. 2024 Mar;14(3):e3459. doi: 10.1002/brb3.3459.
A significant proportion of individuals with suspicious onset of multiple sclerosis (MS) does not fulfill the diagnostic criteria. Although some receive other diagnoses, many remain undiagnosed and lack healthcare follow-up. This study aimed to characterize persons with undetermined diagnosis (PwUD) through a questionnaire.
Incident cases with suspected MS were consecutively admitted to a tertiary neurological healthcare center in a prospective cohort study. Those who remained undiagnosed after 40 months (mean, range 31-52) were considered PwUD. They completed a modified questionnaire, previously used in a population-based case-control study of incident MS cases. Their responses were compared with two control cohorts, persons with MS (PwMS) and healthy controls, randomly selected from national registries, matched by age, gender, and area of residence.
Out of 271 patients with suspected MS onset, 72 (20.3%) were PwUD with a female majority (79%). The response rate was 83% and 39% reported persisting MS-like symptoms. Compared to controls (n = 548) and PwMS (n = 277), fewer PwUD were currently smoking (p = .4 and p = .03), consumed less alcohol (p = .04 and p = .01), and had children (p = .02 and p = .002). PwUD reported occurrence of other autoimmune disease in 29%, higher compared to PwMS and controls (p < .001 and p < .001).
UD is common among persons investigated for suspected MS, in particular among female parents. Our data suggest that PwUD can be characterized as nonsmokers with low alcohol consumption and a higher prevalence of autoimmune disease, in particular thyroid disease.
相当一部分多发性硬化症（MS）可疑发作的患者不符合诊断标准。虽然有些人得到了其他诊断，但仍有许多人未被诊断，缺乏医疗保健随访。本研究旨在通过问卷调查来描述未确定诊断的患者（PwUD）。
在一项前瞻性队列研究中，连续收治有疑似 MS 的病例进入三级神经保健中心。那些在 40 个月（平均，范围 31-52）后仍未被诊断的患者被认为是 PwUD。他们完成了一份修改后的问卷，该问卷之前用于一项基于人群的 MS 新发病例病例对照研究。将他们的回答与从国家登记处随机选择的两组对照进行比较，一组是 MS 患者（PwMS），另一组是健康对照，按照年龄、性别和居住地区匹配。
在 271 例疑似 MS 起病的患者中，有 72 例（20.3%）为 PwUD，以女性为主（79%）。应答率为 83%，39%的人报告仍有 MS 样症状。与对照组（n=548）和 PwMS（n=277）相比，PwUD 目前吸烟的比例较低（p=0.4 和 p=0.03），饮酒量较少（p=0.04 和 p=0.01），并且有孩子的比例较低（p=0.02 和 p=0.002）。PwUD 报告发生其他自身免疫性疾病的比例为 29%，高于 PwMS 和对照组（p<0.001 和 p<0.001）。
在怀疑 MS 的患者中，UD 很常见，特别是在女性父母中。我们的数据表明，PwUD 可以被描述为不吸烟、饮酒量低、自身免疫性疾病患病率较高的患者，特别是甲状腺疾病。
