Familial History of Autoimmune Disorders Among Patients With Pediatric Multiple Sclerosis

Background and ObjectiveThe objective of this study was to determine whether family members of patients with pediatric multiple sclerosis (MS) have an increased prevalence of autoimmune conditions compared with controls.MethodsData collected during a pediatric MS case-control study of risk factors included information about various autoimmune diseases in family members. The frequency of these disorders was compared between cases and controls.ResultsThere was an increased rate of autoimmune diseases among family members of pediatric MS cases compared with controls with first-degree history of MS excluded (OR = 2.27, 95% CI 1.71–3.01, p < 0.001). There was an increased rate of MS among second-degree relatives of pediatric MS cases compared with controls (OR = 3.47, 95% CI 1.36–8.86, p = 0.009). The OR for MS was 2.64 when restricted to maternal relatives and 6.37 when restricted to paternal relatives.DiscussionThe increased rates of autoimmune disorders, including thyroid disorders and MS among families of patients with pediatric MS, suggest shared genetic factors among families with children diagnosed with pediatric MS.

FEATURES OF PEDIATRIC MULTIPLE SCLEROSIS

Background. Demyelinating diseases are one of the most pressing and debatable problems in neurology. Despite the emergence of improved diagnostic criteria and new directions in therapy, multiple sclerosis is a leading cause of disability among young patients. According to epidemiological studies, about 3 million people worldwide suffer from multiple sclerosis. At the same time, from 2.7 to 10.5% of all cases of multiple sclerosis worldwide are observed in children under the age of 18, with a tendency towards an increase in the disease incidence. Purpose. To analyze the results of scientific studies of cases of childhood multiple sclerosis. Material and methods. A qualitative analysis of Russian-language and English-language literature sources containing data on cases of childhood multiple sclerosis has been carried out. Results. It has been established that the incidence of multiple sclerosis among pediatric patients is significantly lower in comparison with the adult population. The clinical picture is polymorphic and, in some cases, atypical. Conclusions. Current understanding of the term "pediatric multiple sclerosis" indicates a narrow window of onset with cognitive decline different from adults, combined with a higher number of relapses and more inflammatory lesions compared to adult multiple sclerosis. The polymorphic clinical picture and atypical manifestations of multiple sclerosis in childhood, as well as the debut in the form of a clinically isolated syndrome, can complicate early differential diagnosis and increase the interval from the onset of the disease to the administration of the necessary pharmacotherapy, which can reduce the severity of the course of the disease, the frequency of relapses and increase the interval "debut - disability".

Needs and Experiences of Children and Adolescents with Pediatric Multiple Sclerosis and Their Caregivers: A Systematic Review

In the present study we conduct a systematic review to evaluate the needs and experience of people with pediatric multiple sclerosis (MS) and their caregivers. The literature search was conducted across 10 academic databases, adhering to PRISMA-P guidelines. Quality appraisal was conducted using the mixed method appraisal test for individual studies, and GRADE-CERQual to establish overall confidence of findings. Results were analyzed using a process of narrative synthesis. We identified 26 studies which included 2253 children/adolescents with MS (CAMS) and 1608 caregivers. MS was reported to negatively impact experiences for CAMS in domains such as of school performance, social relationships, mental health, and overall physical functioning. Specifically, fatigue and social support were reported as the most important barriers and facilitators for CAMS, respectively. In terms of caregiver experience, negative impacts were reported on social functioning, mental health, and quality of life. Additionally, lack of awareness concerning MS was one of the biggest challenges reported. Caregivers expressed needs for psychological and social support. This study provides the first evidence regarding the needs and experiences of CAMS and their caregivers. Findings can be used to address policy gaps for supporting families affected by pediatric MS.