RESEARCH - Autoimmune disease in families with MS: a population-based study

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Lancet Neurol. 2007 Jul;6(7):604-10.

Autoimmune disease in families with multiple sclerosis: a

population-based study.

Ramagopalan SV, Dyment DA, Valdar W, Herrera BM, Criscuoli M, Yee IM,

Sadovnick AD, Ebers GC; Canadian Collaborative Study Group.

Wellcome Trust Centre for Human Genetics, Oxford, UK.

BACKGROUND: Evidence of an association between multiple sclerosis (MS)

and other autoimmune diseases would substantiate the hypothesis that

MS is an autoimmune disease, and implicate a common mechanism. We

aimed to investigate and compare the rate of autoimmune disease in MS

patients, in their first-degree relatives, and in their unrelated

spouses. METHODS: We used data from a national, multicentre,

population-based sample to investigate the rate of autoimmune disease

in 5031 MS patients, 30 259 of their first-degree relatives, and 2707

spousal controls. We asked patients and controls whether they had any

of ten autoimmune diseases: Crohn's disease, ulcerative colitis,

rheumatoid arthritis, type 1 diabetes, psoriasis, pernicious anaemia,

systemic lupus erythematosus, autoimmune thyroid disease, vitiligo,

and myasthenia gravis. MS probands were also asked whether their

first-degree relatives had Crohn's disease, ulcerative colitis,

rheumatoid arthritis, or type 1 diabetes. FINDINGS: After correction

for age and sex, we did not identify any increased risk of autoimmune

diseases in MS patients compared with their spousal controls (odds

ratio [OR]=1.07, 95% CI 0.86-1.23, chi(2)=0.47, p=0.49), or in the

first-degree relatives of MS probands compared with controls (OR=0.89,

0.63-1.17, chi(2)=1.11, p=0.29). However, the reported frequency of

autoimmune diseases did differ according to the sex of the interviewee

(female vs male patients chi(2)=92.2, p<0.0001; female vs male spousal

controls chi(2)=87.1, p<0.0001). MS patients had slightly higher rates

of thyroid disease and pernicious anaemia than did controls, which is

consistent with MHC associations for these diseases, but this effect

disappeared when results were adjusted for sex. For eight other

diseases the rates were similar in MS patients and controls. Families

with multiple cases of MS were no more likely to report autoimmune

diseases than families with single MS cases.

INTERPRETATION: When data were adjusted for sex, no excess of common

autoimmune diseases could be identified in MS patients or their

families, including multicase pedigrees. Our results suggest that

women are more aware of family medical histories than men, which

emphasises the potential for ascertainment bias in unstratified data

for a sex-limited disease. Family histories should thus be taken from

male patients in the presence of a spouse.

PMID: 17560172

http://www.ncbi.nlm.nih.gov/pubmed/17560172

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Not an MD