J of IMAB 2011; 17(1):203-205
MULTIPLE SCLEROSIS ASSOCIATED WITH ANAEMIC SYNDROME: A RETROSPECTIVE ANALYSIS AND LITERATURE REVIEW
Nadezhda S. Deleva, Alexandra J. Tzoukeva, Ara G. Kaprelyan, Kalina V. Drenska.
Department of Neurology, Medical University - Varna, Bulgaria

ABSTRACT:
An association of MS with different anaemic syndromes, most often pernicious and Vit. B12 deficiency anaemia has been reported in the literature. Accordingly, the coincidence of anaemia with MS has been considered to impact seriously on clinical presentation, therapeutic strategy and patient´s quality of life.
Objective: To perform a retrospective analysis of 18 cases with anaemic syndrome as a factor of comorbidity in patients with MS.
Material and methods: 18 MS patients (15 women and 3 men) with RRMS (13), PPMS (2), and SPMS (3) diagnosed according to McDonald criteria were included in the present study. Average age was 36.4±8.5 (22-42) years, average disease duration 10.6±6.8 (4-18) years and means EDSS - 3.5±2.5 points (2-6). All individuals underwent clinical, MRI and hematological examinations.
Results: The study group included patients with pernicious (n=8), Vitamin B12 (n=6), and iron (n=3) deficiency anaemia, as well as with  β-thalassemia (n=1). In 12 patients anaemic syndrome proceeded MS and in 6 evolved during the course of the desease.
Conclusion: Our own notices and literature review suggests a possible causative relation between MS and anaemic syndrome. The role of this coincidence on clinical presentation, necessity of additional treatment, and patient´s quality of life is discussed.

Key words: MS, vitamin B 12 deficiency, pernicious anaemia, iron deficiency anaemia.

- Download FULL TEXT ( PDF 183 KB )
Please cite this article as: Deleva NS, Tzoukeva AJ, Kaprelyan AG, Drenska KV. MULTIPLE SCLEROSIS ASSOCIATED WITH ANAEMIC SYNDROME: A RETROSPECTIVE ANALYSIS AND LITERATURE REVIEW. J of IMAB. 2012; 18(1):203-205. DOI: 10.5272/jimab.2012181.203.

REFERENCES:
1. Alanoglu G, Kilbas S, Arslan C, Senol A, Kultuhan S. Autoimmune hemolytic anemia during interferon-beta-I b treatment for multiple sclerosis. Mult Scler. 2007 Jun;13(5):683-5. Epub 2007 Mar 15. [PubMed]
2. Najim al-Din AS, Khojali M., Habbosh H., Farah S., Idris AR, Al-Muhtasib F. Macrocytosis in multiple sclerosis. A study in 82 de novo Arab patients. J Neurol Neurosurg Psychiatry. 1991 May;54:415-416. [PubMed] [CrossRef]
3. Belniak E., Stelmasiak Z., Papuć E. Multiple sclerosis and other autoimmune diseases. Neurol Neurochir Pol. 2007 May-Jun;41(3):259-266. (Article in Polish) [PubMed]
4. Gruener D., Kunkel E., Snyderman D., Infante M., Rodgers C., Field H. Dietary vitamin B12 deficiency in a patient with multiple sclerosis. Gen Hosp Psychiatry. 1994 May;16(3):224-228. [PubMed]
5. Hinterberger-Fischer M., Kier P., Forstinger I., Lechner K., Kornek G., Breyer S., et al. Coincidence of severe aplastic anaemia with multiple sclerosis or thyroid disorders. Report of 5 cases. Acta haematologica.1994; 93(3):136-139. [PubMed]
6. Kang J., Chen Y., Lin H. Comorbidities amongst patients with multiple sclerosis: a population-based controlled study. Eur J Neurol. 2010 Sep;17(9):1215-1219. Epub 2010 Feb 23. [PubMed] [CrossRef]
7. Marrie R., Horwitz R. Emerging effects of comorbidities on multiple sclerosis. Lancet Neurol. 2010 Aug;9(8):820-828. [PubMed] [CrossRef]
8. Marrie R., Horwitz R., Cutter G, Tyry T, Vollmer T. Association between comorbidity and clinical characteristics of MS. Acta Neurol Scand. 2011 Aug;124(2):135-141. Epub 2010 Sep 29. [PubMed] [CrossRef]
9. Miller A, Korem M, Almog R, Galboiz Y. Vitamin B12, demyelination, remyelination and repair in multiple sclerosis. J Neurol Sci. 2005 Jun 15;233(1-2):93-97. [PubMed] [CrossRef]
10. Ramsaransing G., Fokkema M., Teelken A., Arutjunyan A., Koch M., De Keyser J. Plasma homocysteine levels in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2006 Feb;77(2):189-192. [PubMed] [CrossRef]
11. Reynolds E. Multiple sclerosis and vitamin B12 metabolism. J Neuroimmunol. 1992 Oct;40(2-3):225-230. [PubMed]
12. Söderberg KC, Jonsson F., Winqvist O., Hagmar L., Feychting M. Autoimmune diseases, asthma and risk of haematological malignancies: a nationwide case-control study in Sweden. Eur J Cancer. 2006 Nov;42(17):3028-3033. Epub 2006 Sep 1. [PubMed] [CrossRef]
13. Triantafyllou N., Evangelopoulos ME, Kimiskidis VK, Kararizou E., Boufidou F., Fountoulakis KN, et al. Increased plasma homocysteine levels in patients with multiple sclerosis and depression. Ann Gen Psychiatry. 2008 Sep 9;7:17 [PubMed] {CrossRef].

Accepted for publication: 08 December 2011
Issue published online: 07 February 2012

back to Online Journal