Contributions
Abstract: P836
Type: Poster
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: It is hard to predict a future diagnosis of multiple sclerosis (MS) at the onset of acquired demyelinating syndromes (ADS) in childhood. MRI lesion type and CSF oligoclonal bands (OCB) contribute to prediction, but additional markers remain needed. In adult MS, elevated levels of soluble CD27 (sCD27), that is released upon T-cell activation, are found in CSF. This marker appears an accurate biomarker for MS-related neuro-inflammation. We here examined whether quantification of CSF sCD27 can distinguish a monophasic versus multiphasic disease course after pediatric ADS.
Methods: Children < 18 years old included in the Dutch Nationwide ADS study were eligible if a lumbar puncture was performed within 6 months after onset. sCD27 levels were determined by a commercially available ELISA (Sanquin, Amsterdam). Mann Whitney U and Kruskal Wallis test were used to compare continuous parameters that were not normally distributed. Chi-square and Fisher exact test were used for categorical data.
Results: Sixty-seven children were included (26 acute disseminated encephalomyelitis (ADEM), 12 clinically isolated syndrome (CIS) and 29 MS). Thirty-nine patients were female (58%). Median age of onset was 10.8 years. A multiphasic disease course was observed in 21 patients (31%) with a median follow-up duration of 3.0 years.
Multiphasic patients had a higher sCD27 level compared to monophasic patients (median 43.9 pg/ml, IQR 32.8-97.6 vs median 17.8 pg/ml, IQR 9.2-38.4 (p< 0.000)). Monophasic CIS patients showed lowest levels of sCD27 (median 9.0 pg/ml), followed by monophasic ADEM (median 19.1 pg/ml), with the highest levels among patients that were diagnosed with MS (median 52.2 pg/ml). The sCD27 levels differed significantly among these groups (p< 0.000).
Conclusion: sCD27 levels in CSF of pediatric ADS patients is associated with a multiphasic disease course, with the highest levels in MS patients. This seems to be a promising new biomarker for prediction of MS at ADS onset.
Disclosure: YYM Wong: nothing to disclose
ED van Pelt: nothing to disclose
IA Ketelslegers: nothing to disclose
CE Catsman-Berrevoets: nothing to disclose
RF Neuteboom: nothing to disclose
RQ Hintzen: nothing to disclose
This study was supported by the Dutch Multiple Sclerosis research foundation
Abstract: P836
Type: Poster
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: It is hard to predict a future diagnosis of multiple sclerosis (MS) at the onset of acquired demyelinating syndromes (ADS) in childhood. MRI lesion type and CSF oligoclonal bands (OCB) contribute to prediction, but additional markers remain needed. In adult MS, elevated levels of soluble CD27 (sCD27), that is released upon T-cell activation, are found in CSF. This marker appears an accurate biomarker for MS-related neuro-inflammation. We here examined whether quantification of CSF sCD27 can distinguish a monophasic versus multiphasic disease course after pediatric ADS.
Methods: Children < 18 years old included in the Dutch Nationwide ADS study were eligible if a lumbar puncture was performed within 6 months after onset. sCD27 levels were determined by a commercially available ELISA (Sanquin, Amsterdam). Mann Whitney U and Kruskal Wallis test were used to compare continuous parameters that were not normally distributed. Chi-square and Fisher exact test were used for categorical data.
Results: Sixty-seven children were included (26 acute disseminated encephalomyelitis (ADEM), 12 clinically isolated syndrome (CIS) and 29 MS). Thirty-nine patients were female (58%). Median age of onset was 10.8 years. A multiphasic disease course was observed in 21 patients (31%) with a median follow-up duration of 3.0 years.
Multiphasic patients had a higher sCD27 level compared to monophasic patients (median 43.9 pg/ml, IQR 32.8-97.6 vs median 17.8 pg/ml, IQR 9.2-38.4 (p< 0.000)). Monophasic CIS patients showed lowest levels of sCD27 (median 9.0 pg/ml), followed by monophasic ADEM (median 19.1 pg/ml), with the highest levels among patients that were diagnosed with MS (median 52.2 pg/ml). The sCD27 levels differed significantly among these groups (p< 0.000).
Conclusion: sCD27 levels in CSF of pediatric ADS patients is associated with a multiphasic disease course, with the highest levels in MS patients. This seems to be a promising new biomarker for prediction of MS at ADS onset.
Disclosure: YYM Wong: nothing to disclose
ED van Pelt: nothing to disclose
IA Ketelslegers: nothing to disclose
CE Catsman-Berrevoets: nothing to disclose
RF Neuteboom: nothing to disclose
RQ Hintzen: nothing to disclose
This study was supported by the Dutch Multiple Sclerosis research foundation