Bharti Jayshankar
December 28, 2024: A recent research reveals that certain symptoms precede a diagnosis of multiple sclerosis (MS) in pediatric patients.
The study, published in JAMA Network Open involving over 1,000 children and adolescents, suggests that various health issues manifest in the five years leading up to an MS diagnosis, potentially indicating a prodromal phase of the disease.
The study analyzed data from 1,091 children and adolescents with MS in Germany with statutory health insurance from January 2010 to December 2020. The study population consisted of 3 groups: case individuals with MS, control individuals without MS, and control individuals with juvenile idiopathic arthritis (JIA).
It was found that in participants diagnosed with MS, several disorders were significantly more prevalent compared to matched controls. The most common conditions observed were:
Obesity: This condition was observed with an adjusted odds ratio (AOR) of 1.70, indicating a strong association with MS.
Visual disturbances: With an AOR of 1.31, these symptoms were frequently reported.
Gastritis: Gastrointestinal issues showed an AOR of 1.35.
Patella disorders: Musculoskeletal problems had an AOR of 1.47.
Heartbeat abnormalities: These cardiovascular symptoms were notably higher with an AOR of 1.94.
Flatulence: This gastrointestinal symptom had an AOR of 1.43.
Skin sensation disturbances: This symptom was significantly associated with MS, showing an astonishing AOR of 12.93.
Dizziness: These symptoms also appeared more frequently, with an AOR of 1.52.
Implications for early diagnosis of MS
The findings suggest that children and adolescents with MS experience a variety of metabolic, ocular, musculoskeletal, gastrointestinal, and cardiovascular symptoms before their first diagnosis. The study authors involved in the study, stated, “This research highlights the importance of recognizing early signs and symptoms that could lead to earlier diagnosis and treatment of MS in young patients.”
Previous research
Research indicates that specific genetic factors significantly increase the risk of pediatric multiple sclerosis. Key genetic factors include the HLA-DRB1*15:01 allele. A meta-analysis shows an odds ratio of 2.95, indicating that children carrying this variant are nearly three times more likely to develop MS compared to those without it
The study also found that 28 out of 104 non-MHC (histocompatibility complex )genetic variants were associated with pediatric MS. These variants contribute to a higher genetic burden in pediatric patients compared to adults, although the difference was not statistically significant.
Variations in the IL7R gene have also been implicated in MS risk, alongside environmental factors such as exposure to the Epstein-Barr virus (EBV) and low vitamin D levels.
The study emphasizes the need for healthcare providers to be aware of the stated potential prodromal symptoms. By identifying these signs early, clinicians may improve outcomes for pediatric patients by facilitating timely interventions.
