Antonis Fanouriakis1, Vasileios Mastorodemos2, Cristina Pamfil3, Efrosini Papadaki4, Prodromos Sidiropoulos1, Andreas Plaitakis2, George Amoiridis2, George Bertsias5, Dimitrios T Boumpas6. 1. Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Heraklion, Greece. 2. Department of Neurology, University Hospital of Heraklion, Heraklion, Greece. 3. "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. 4. Department of Medical Imaging-MRI Unit, University Hospital of Heraklion, Heraklion, Greece. 5. Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Heraklion, Greece; Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology-Hellas, Voutes, Heraklion, Greece. 6. Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Heraklion, Greece; Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology-Hellas, Voutes, Heraklion, Greece; Biomedical Research Foundation of the Academy of Athens, Athens, Greece. Electronic address: boumpasd@med.uoc.gr.
Abstract
OBJECTIVES: The coexistence of systemic lupus erythematosus (SLE) and multiple sclerosis (MS) in the same individual has rarely been described. Our objective was to report on the prevalence, clinical characteristics, and prognosis of cases fulfilling the criteria for both SLE and MS. METHODS: We utilized existing patient cohorts from the Departments of Rheumatology and Neurology, University of Crete, and screened patients diagnosed with either SLE (n = 728) or MS (n = 819) for features of both diseases. The clinical, laboratory, and neuroimaging findings were assessed. RESULTS: We identified nine patients who fulfilled the diagnostic criteria for both SLE and MS, corresponding to a prevalence rate of 1.0-1.2% in each cohort. All patients were women, with an average age at SLE diagnosis of 42.1 years (range: 34-56 years). The diagnosis of SLE preceded the development of MS in five patients, with a time lag ≤ 5 years in four of them. Initial presentation of MS included spinal symptoms in seven patients. All patients had features of mild SLE with predominantly cutaneous, mucosal, and musculoskeletal manifestations. Accordingly, therapeutic decisions were mainly guided by the severity of the neurological syndrome. During the median follow-up of 4 years (range: 1-10 years), three patients remained stable and the remaining experienced gradual deterioration in their neurological status. SLE remained quiescent in all patients while on standard immunomodulatory MS therapy. CONCLUSIONS: Occurrence of both diseases in the same individual is rare, corroborating data that suggest distinct molecular signatures. SLE and MS coexistence was not associated with a severe phenotype for either entity.
OBJECTIVES: The coexistence of systemic lupus erythematosus (SLE) and multiple sclerosis (MS) in the same individual has rarely been described. Our objective was to report on the prevalence, clinical characteristics, and prognosis of cases fulfilling the criteria for both SLE and MS. METHODS: We utilized existing patient cohorts from the Departments of Rheumatology and Neurology, University of Crete, and screened patients diagnosed with either SLE (n = 728) or MS (n = 819) for features of both diseases. The clinical, laboratory, and neuroimaging findings were assessed. RESULTS: We identified nine patients who fulfilled the diagnostic criteria for both SLE and MS, corresponding to a prevalence rate of 1.0-1.2% in each cohort. All patients were women, with an average age at SLE diagnosis of 42.1 years (range: 34-56 years). The diagnosis of SLE preceded the development of MS in five patients, with a time lag ≤ 5 years in four of them. Initial presentation of MS included spinal symptoms in seven patients. All patients had features of mild SLE with predominantly cutaneous, mucosal, and musculoskeletal manifestations. Accordingly, therapeutic decisions were mainly guided by the severity of the neurological syndrome. During the median follow-up of 4 years (range: 1-10 years), three patients remained stable and the remaining experienced gradual deterioration in their neurological status. SLE remained quiescent in all patients while on standard immunomodulatory MS therapy. CONCLUSIONS: Occurrence of both diseases in the same individual is rare, corroborating data that suggest distinct molecular signatures. SLE and MS coexistence was not associated with a severe phenotype for either entity.
Authors: Ruth Ann Marrie; Nadia Reider; Jeffrey Cohen; Olaf Stuve; Per S Sorensen; Gary Cutter; Stephen C Reingold; Maria Trojano Journal: Mult Scler Date: 2014-12-22 Impact factor: 6.312
Authors: Ruth Ann Marrie; Jeffrey Cohen; Olaf Stuve; Maria Trojano; Per Soelberg Sørensen; Stephen Reingold; Gary Cutter; Nadia Reider Journal: Mult Scler Date: 2015-01-26 Impact factor: 6.312
Authors: Elisa Carolina Jácome Sánchez; María Ariana García Castillo; Victor Paredes González; Fernando Guillén López; Edgar Patricio Correa Díaz Journal: Mult Scler J Exp Transl Clin Date: 2018-04-08