Clinical and MRI Correlates of Antinuclear Antibodies in Multiple Sclerosis Patients

Background Antinuclear antibodies (AAB) are more common in patients with multiple sclerosis (MS) than in the general population and the presence of these antibodies often leads to uncertainty regarding disease course, response to treatment and diagnosis of MS. This study aims to assess the frequency of elevated AABs in MS patients at the time of diagnosis and to identify its impact on clinical and radiological evolution in a Tunisian population. Material(s) and Method(s) We conducted a case-control study, including patients from the neurology department of Habib Bourguiba Hospital (Sfax, Tunisia), whose diagnosis of MS was retained between October 2018 and October 2020. All patients were screened for antinuclear antibodies and underwent brain magnetic imaging (MRI). Result(s) We included 30 patients and 30 age- and sex-matched controls. AABs were positive in 8 patients (26.6%) and 4 controls (13.3%). The titer was ≥1/320 in 3 patients and 1 control. Antigenic specificity was detected in 2 patients. It was anti-SSB in 1 case, and anti-histone in the other case. We did not find any significant difference in terms of positivity of these markers with the control group (p>0.05). There was a correlation between AAB positivity and age at onset of MS (p = 0.04). In fact, patients who had a positive AAB had an older age of onset. However, AAB status had no impact on the Expanded Disability Status Scale (EDSS) (p = 0.86) or radiological disease activity (p = 0.18). Conclusion(s) Screening for AAB is frequently prescribed in the context of central nervous system inflammation because many of the neurological manifestations described in MS can be seen in other pathological disorders associated with AAB. Our study revealed the association of AAB positivity with advanced age of disease onset. This finding has not been previously reported in the literature. Antinuclear antibodies (AAB) are more common in patients with multiple sclerosis (MS) than in the general population and the presence of these antibodies often leads to uncertainty regarding disease course, response to treatment and diagnosis of MS. This study aims to assess the frequency of elevated AABs in MS patients at the time of diagnosis and to identify its impact on clinical and radiological evolution in a Tunisian population. We conducted a case-control study, including patients from the neurology department of Habib Bourguiba Hospital (Sfax, Tunisia), whose diagnosis of MS was retained between October 2018 and October 2020. All patients were screened for antinuclear antibodies and underwent brain magnetic imaging (MRI). We included 30 patients and 30 age- and sex-matched controls. AABs were positive in 8 patients (26.6%) and 4 controls (13.3%). The titer was ≥1/320 in 3 patients and 1 control. Antigenic specificity was detected in 2 patients. It was anti-SSB in 1 case, and anti-histone in the other case. We did not find any significant difference in terms of positivity of these markers with the control group (p>0.05). There was a correlation between AAB positivity and age at onset of MS (p = 0.04). In fact, patients who had a positive AAB had an older age of onset. However, AAB status had no impact on the Expanded Disability Status Scale (EDSS) (p = 0.86) or radiological disease activity (p = 0.18). Screening for AAB is frequently prescribed in the context of central nervous system inflammation because many of the neurological manifestations described in MS can be seen in other pathological disorders associated with AAB. Our study revealed the association of AAB positivity with advanced age of disease onset. This finding has not been previously reported in the literature.