Retrospective analysis of pediatric multiple sclerosis in the Republic of Bashkortostan

Abstract

BACKGROUND: Multiple sclerosis (MS) primarily starts in the young and may develop in children. The ratio of girls to boys younger than 10–12 is 1:1, and after puberty is 3:1. During puberty, monosymptomatic exacerbations and remitting MS are more common. An increased prevalence in pediatric patients is observed.

AIM: The paper assesses clinical and epidemiological attributes of pediatric-onset MS in the Republic of Bashkortostan.

MATERIALS AND METHODS: Clinical and epidemiological attributes of pediatric MS patients were compared with typical-onset patients. Statistics were analyzed using Statistica 22.0.

RESULTS: In the Republic of Bashkortostan, 113 cases of pediatric-onset multiple sclerosis (MS) have been recorded, which is 4.2% of the total MS cases. The prevalence of pediatric MS is 2.5 cases, the incidence is 1.3 per 100,000 children. The population is predominantly urban. Prior to MS onset, all patients had suffered from acute respiratory viral infections, and the majority (94.2%) had suffered from chickenpox. Females predominate with the ratio of 2.6:1. The average progression rate of neurologic deficit is 0.2 points per year (0.1; 1.3). In cases with the onset after 18, the rate is 0.3 points per year (0.3; 2.4); p=0.761. All pediatric patients have a relapsing-remitting MS. No significant differences were found in the clinical manifestations of pediatric- and adult-onset MS ( p<0.05).

CONCLUSION: It is required to expand clinical and epidemiological studies of multiple sclerosis (MS) in the pediatric population to ensure better diagnosis and early administration of the relevant pathogenetic therapy.

Keywords

pediatric / multiple sclerosis / clinical and epidemiological attributes

References

[1] Gusev EI, Boyko AN. Multiple sclerosis: a scientific and practical guide in two volumes. Vol. 1. Moscow: ROOI "Human Health"; 2020. (In Russ.)

[2] Гусев Е.И., Бойко А.Н. Рассеянный склероз: научно-практическое руководство в двух томах. Т. 1. Москва: РООИ «Здоровье человека», 2020.

[3] Valis M, Pavelek Z, Novotny M, et al. Analysis of the group of pediatric patients with relapsing-remitting multiple sclerosis: data from the Czech national registry. Front Neurol. 2022;13:851426. doi: 10.3389/fneur.2022.851426

[4] Valis M., Pavelek Z., Novotny M., et al. Analysis of the group of pediatric patients with relapsing-remitting multiple sclerosis: data from the Czech national registry // Front Neurol. 2022. Vol. 13. P. 851426. doi: 10.3389/fneur.2022.851426

[5] Sivertseva SA, Bykova OV, Bakhtiyarova KZ, et al. Clinical cases of multiple sclerosis in children with cerebral palsy. S.S. Korsakov Journal of Neurology and Psychiatry. 2018;118(8–2):55–61. EDN: YBMCDB doi: 10.17116/jnevro201811808255

[6] Сиверцева С.А., Быкова О.В., Бахтиярова К.З., и др. Клинические случаи рассеянного склероза у детей с церебральным параличом // Журнал неврологии и психиатрии им. С.С. Корсакова. 2018. Т. 118, № 8–2. С. 55–61. EDN: YBMCDB doi: 10.17116/jnevro201811808255

[7] Hardy D, Chitnis T, Waubant E, Banwell B. Preventing multiple sclerosis: the pediatric perspective. Front Neurol. 2022;13:802380. doi: 10.3389/fneur.2022.802380

[8] Hardy D., Chitnis T., Waubant E., Banwell B. Preventing multiple sclerosis: the pediatric perspective // Front Neurol. 2022. Vol. 13. P. 802380. doi: 10.3389/fneur.2022.802380

[9] Alroughani R, Boyko A. Pediatric multiple sclerosis: a review. BMC Neurol. 2018;18(1):27. doi: 10.1186/s12883-018-1026-3

[10] Alroughani R., Boyko A. Pediatric multiple sclerosis: a review // BMC Neurol. 2018. Vol. 18, N 1. Р. 27. doi: 10.1186/s12883-018-1026-3

[11] El’chaninova EYu, Smagina IV. Pediatric multiple sclerosis. Neurological Journal. 2017;22(2):64–71. EDN: YUEYVL

[12] Eльчанинова Е.Ю., Смагина И.В. Педиатрический рассеянный склероз // Неврологический журнал. 2017. Т. 22, № 2. С. 64–71. EDN: YUEYVL

[13] Ghezzi A, Amato MP, Makhani N, et al. Pediatric multiple sclerosis: Conventional first-line treatment and general management. Neurology. 2016;87(9 Suppl 2):S97–S102. doi: 10.1212/WNL.0000000000002823

[14] Ghezzi A., Amato M.P., Makhani N., et al. Pediatric multiple sclerosis: Conventional first-line treatment and general management // Neurology. 2016. Vol. 87, N 9 Suppl 2. P. S97–S102. doi: 10.1212/WNL.0000000000002823

[15] Kornbluh AB, Kahn I. Pediatric multiple sclerosis. Semin Pediatr Neurol. 2023;46:101054. doi: 10.1016/j.spen.2023.101054

[16] Kornbluh A.B., Kahn I. Pediatric multiple sclerosis // Semin Pediatr Neurol. 2023. Vol. 46. P. 101054. doi: 10.1016/j.spen.2023.101054

[17] Ahn JJ, O'Mahony J, Moshkova M, et al. Puberty in females enhances the risk of an outcome of multiple sclerosis in children and the development of central nervous system autoimmunity in mice. Mult Scler. 2015;21(6):735–748. doi: 10.1177/1352458514551453

[18] Ahn J.J., O'Mahony J., Moshkova M., et al. Puberty in females enhances the risk of an outcome of multiple sclerosis in children and the development of central nervous system autoimmunity in mice. // Mult Scler. 2015. Vol. 21, N 6. P. 735–748. doi: 10.1177/1352458514551453

[19] Haki M, Al-Biati HA, Al-Tameemi, ZS, et al. Review of multiple sclerosis: Epidemiology, etiology, pathophysiology, and treatment. Medicine (Baltimore). 2024;103(8):e37297. doi: 10.1097/MD.0000000000037297

[20] Haki M., Al-Biati H.A., Al-Tameemi Z.S., et al. Review of multiple sclerosis: epidemiology, etiology, pathophysiology, and treatment // Medicine (Baltimore). 2024. Vol. 103, N 8. P. e37297 doi: 10.1097/MD.0000000000037297

[21] de Chalus A, Taveira M, Deiva K. Pediatric onset multiple sclerosis: Future challenge for early diagnosis and treatment. Presse Med. 2021;50(2):104069. doi: 10.1016/j.lpm.2021.104069

[22] de Chalus A., Taveira M., Deiva K. Pediatric onset multiple sclerosis: Future challenge for early diagnosis and treatment // Presse Med. 2021. Vol. 50, N 2. P. 104069. doi: 10.1016/j.lpm.2021.104069

[23] Bakhtiyarova KZ, Lyutov OV, Talipova ID, et al. Epidemiological characteristics of multiple sclerosis in the Republic of Bashkortostan : Abstracts of the 5th Congress on Multiple Sclerosis and Other Demyelinating Diseases (Ufa, September 28–30, 2023). S.S. Korsakov Journal of Neurology and Psychiatr. 2023;123(7–2):136–180. doi: 10.17116/jnevro2023123072136

[24] Бахтиярова К.З., Лютов О.В., Талипова И.Д., и др. Эпидемиологическая характеристика рассеянного склероза в Республике Башкортостан : Тезисы 5-го Конгресса по рассеянному склерозу и другим демиелинизирующим заболеваниям (Уфа, 28–30 сентября 2023 г.) // Журнал неврологии и психиатрии им. С.С. Корсакова. 2023. Т. 123, № 7–2. С. 136–180. doi: 10.17116/jnevro2023123072136

[25] Timasheva YR, Nasibullin TR, Tuktarova IA, et al. Multilocus evaluation of genetic predictors of multiple sclerosis. Gene , 2022;809:146008. doi: 10.1016/j.gene.2021.146008

[26] Timasheva Y.R., Nasibullin T.R., Tuktarova I.A., et al. Multilocus evaluation of genetic predictors of multiple sclerosis // Gene. 2022. Vol. 809. P. 146008. doi: 10.1016/j.gene.2021.146008

[27] Utyagulova NF, Galiullin TR, Bakhtiyarova KZ, Lyutov OV. Pediatric multiple sclerosis in Bashkortostan Republic. Practical Medicine. 2020;18(5):76–78. EDN: LZLCJL doi: 10.32000/2072-1757-2020-5-76-78

[28] Утягулова Н.Ф., Галиуллин Т.Р, Бахтиярова К.З., Лютов О.В. Рассеянный склероз у детей в Республике Башкортостан // Практическая медицина. 2020. Т. 18, № 5. С. 76–78. EDN: LZLCJL doi: 10.32000/2072-1757-2020-5-76-78

[29] Goncharova ZA, Pogrebnova YuYu, Trinitatskiy YuV, Sycheva TV. Familial multiple sclerosis: literature review, own data analysis. Practical Medicine. 2020;18(5):69–75. EDN: RUDZNJ doi: 10.32000/2072-1757-2020-5-69-75

[30] Гончарова З.А., Погребнова Ю.Ю., Тринитатский Ю.В, Сычева Т.В. Семейный рассеянный склероз: обзор литературы, анализ собственных данных // Практическая медицина. 2020. Т. 18, № 5. С. 69–75. EDN: RUDZNJ doi: 10.32000/2072-1757-2020-5-69-75

[31] Khabirov FA, Khaybullin TI, Granatov EV, et al. Multiple sclerosis in the Republic of Tatarstan: epidemiological and clinical characteristics. Practical Medicine. 2020;18(5):50–57. EDN: DVTHND doi: 10.32000/2072-1757-2020-5-50-57

[32] Хабиров Ф.А., Хайбуллин Т.И., Гранатов Е.В., и др. Рассеянный склероз в Республике Татарстан: клинико-эпидемиологическая характеристика // Практическая медицина. 2020. Т. 18, № 5. С. 50–57. EDN: DVTHND doi: 10.32000/2072-1757-2020-5-50-57

[33] Boyko A, Melnikov M. Prevalence and incidence of multiple sclerosis in Russian Federation: 30 years of studies. Brain Sci. 2020;10(5):305. doi: 10.3390/brainsci10050305

[34] Boyko A., Melnikov M. Prevalence and incidence of multiple sclerosis in Russian Federation: 30 years of studies // Brain Sci. 2020. Vol. 10, N 5. P. 305. doi: 10.3390/brainsci10050305

[35] Hottenrott T, Dersch R, Berger B, et al. The intrathecal, polyspecific antiviral immune response in neurosarcoidosis, acute disseminated encephalomyelitis and autoimmune encephalitis compared to multiple sclerosis in a tertiary hospital cohort. Fluids Barriers CNS. 2015;12:27. doi: 10.1186/s12987-015-0024-8

[36] Hottenrott T., Dersch R., Berger B., et al. The intrathecal, polyspecific antiviral immune response in neurosarcoidosis, acute disseminated encephalomyelitis and autoimmune encephalitis compared to multiple sclerosis in a tertiary hospital cohort // Fluids Barriers CNS. 2015. Vol. 12. P. 27. doi: 10.1186/s12987-015-0024-8

[37] Boyko AN, Bykova OV, Sivertseva SA. Disease modifying therapy of multiple sclerosis in children and adolescences. Practical Medicine. 2017;1(1):28-34. EDN: YHZKML

[38] Бойко А.Н., Быкова О.В., Сиверцева С.А. Патогенетическое лечение рассеянного склероза у детей и подростков // Практическая медицина. 2017. Т. 1, № 1. C. 28–34. EDN: YHZKML

[39] Bykova OV, Nankina IA, Drozdova IM, et al. Disease-modifying drugs in pediatric patients with multiple sclerosis. S.S. Korsakov Journal of Neurology and Psychiatry. 2016;116(2–2):44–53. EDN: VQXZCR doi: 10.17116/jnevro20161162244-53

[40] Быкова О.В., Нанкина И.А., Дроздова И.М., и др. Препараты, изменяющие течение рассеянного склероза у детей и подростков // Журнал неврологии и психиатрии им. С.С. Корсакова. 2016. Т. 116, № 2–2. С. 44–53. EDN: VQXZCR doi: 10.17116/jnevro20161162244-53

[41] Spelman T, Simoneau G, Hyde R, et al. Comparative effectiveness of natalizumab, fingolimod, and injectable therapies in pediatric-onset multiple sclerosis: a registry-based study. Neurology. 2024;102(7):e208114. doi: 10.1212/WNL.0000000000208114

[42] Spelman T., Simoneau G., Hyde R., et al. Comparative effectiveness of natalizumab, fingolimod, and injectable therapies in pediatric-onset multiple sclerosis: a registry-based study // Neurology. 2024. Vol. 102, N 7. P. e 208114. doi: 10.1212/WNL.0000000000208114

[43] Malani Shukla N, Casper TC, Ness J, et al. Demographic features and clinical course of patients with pediatric-onset multiple sclerosis on newer disease-modifying treatments. Pediatr Neurol. 2023;145:125–131. doi: 10.1016/j.pediatrneurol.2023.04.020

[44] Malani Shukla N., Casper T.C., Ness J., et al. Demographic features and clinical course of patients with pediatric-onset multiple sclerosis on newer disease-modifying treatments // Pediatr Neurol. 2023. Vol. 145. P. 125–131. doi: 10.1016/j.pediatrneurol.2023.04.020

[45] Sharmin S, Roos I, Malpas CB, et al. Disease-modifying therapies in managing disability worsening in paediatric-onset multiple sclerosis: a longitudinal analysis of global and national registries. Lancet Child Adolesc Health. 2024;8(5):348–357. doi: 10.1016/S2352-4642(24)00047-6

[46] Sharmin S., Roos I., Malpas C.B., et al. Disease-modifying therapies in managing disability worsening in paediatric-onset multiple sclerosis: a longitudinal analysis of global and national registrie // Lancet Child Adolesc Health. 2024. Vol. 8, N 5. P. 348–357. doi: 10.1016/S2352-4642(24)00047-6

[47] Ghezzi A. Old and new strategies in the treatment of pediatric multiple sclerosis: a personal view for a new treatment approach. Neurol Ther. 2024;13(4):949–963. doi: 10.1007/s40120-024-00633-6

[48] Ghezzi A. Old and new strategies in the treatment of pediatric multiple sclerosis: a personal view for a new treatment approach // Neurol Ther. 2024. Vol. 13, N 4. P. 949–963. doi: 10.1007/s40120-024-00633-6

[49] Nasr Z, Casper TC, Waltz M, et al. Clinical and magnetic resonance imaging outcomes in pediatric-onset MS patients on fingolimod and ocrelizumab. Mult Scler Relat Disord. 2024;87:105647. doi: 10.1016/j.msard.2024.105647

[50] Nasr Z., Casper T.C., Waltz M., et al. Clinical and magnetic resonance imaging outcomes in pediatric-onset MS patients on fingolimod and ocrelizumab // Mult Scler Relat Disord. 2024. Vol. 87. P. 105647. doi: 10.1016/j.msard.2024.105647

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