TY - JOUR
T1 - Relapse severity and recovery in early pediatric multiple sclerosis
AU - Fay, Alex J.
AU - Mowry, Ellen M.
AU - Strober, Jonathan
AU - Waubant, Emmanuelle
N1 - Funding Information:
This work was supported by the National Multiple Sclerosis Society. Dr Mowry’s research is funded by the National MS Society (Sylvia Lawry Fellowship Award) and NIH (grant number NIHK23NS067055). Dr Waubant’s research is funded by the National MS Society and the Nancy Davis Foundation.
PY - 2012/7
Y1 - 2012/7
N2 - Background: Factors determining severity and recovery of early demyelinating events in pediatric multiple sclerosis (MS) patients are unknown. Objective: The objective of this study was to characterize the severity and recovery of early demyelinating events in pediatric MS. Methods: Multivariate logistic regression was performed to determine predictors of severe (versus mild/moderate) relapses and poor or fair (versus complete) recovery in patients aged 18 years or less with MS or clinically isolated syndrome (CIS). Results: Optic nerve involvement (OR 4.30, 95% CI 1.50-12.3, p = 0.007) was associated with a severe initial demyelinating event (IDE), while non-White race (OR 2.55, 95% CI 0.87-7.49, p = 0.088), localization to the cerebral hemispheres (OR 7.94, 95% CI 0.86-73.8, p = 0.068), or encephalopathy (OR 8.70, 95% CI 0.86-88.0, p = 0.067) showed a trend towards increased IDE severity. A similar association with race was found for severe second events. A severe IDE (OR 6.90, 95% CI 2.47-19.3, p < 0.001) was associated with incomplete IDE recovery, with similar trends for second and third events. Incomplete recovery from the first event predicted incomplete second event recovery (OR 3.36, 95% CI 0.98-11.6, p = 0.055). Conclusions: These results may help identify children at risk for a more aggressive disease course.
AB - Background: Factors determining severity and recovery of early demyelinating events in pediatric multiple sclerosis (MS) patients are unknown. Objective: The objective of this study was to characterize the severity and recovery of early demyelinating events in pediatric MS. Methods: Multivariate logistic regression was performed to determine predictors of severe (versus mild/moderate) relapses and poor or fair (versus complete) recovery in patients aged 18 years or less with MS or clinically isolated syndrome (CIS). Results: Optic nerve involvement (OR 4.30, 95% CI 1.50-12.3, p = 0.007) was associated with a severe initial demyelinating event (IDE), while non-White race (OR 2.55, 95% CI 0.87-7.49, p = 0.088), localization to the cerebral hemispheres (OR 7.94, 95% CI 0.86-73.8, p = 0.068), or encephalopathy (OR 8.70, 95% CI 0.86-88.0, p = 0.067) showed a trend towards increased IDE severity. A similar association with race was found for severe second events. A severe IDE (OR 6.90, 95% CI 2.47-19.3, p < 0.001) was associated with incomplete IDE recovery, with similar trends for second and third events. Incomplete recovery from the first event predicted incomplete second event recovery (OR 3.36, 95% CI 0.98-11.6, p = 0.055). Conclusions: These results may help identify children at risk for a more aggressive disease course.
KW - demyelinating disease
KW - epidemiology
KW - multiple sclerosis
KW - pediatric
KW - recovery
KW - severity
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U2 - 10.1177/1352458511431725
DO - 10.1177/1352458511431725
M3 - Article
C2 - 22183939
AN - SCOPUS:84863213666
SN - 1352-4585
VL - 18
SP - 1008
EP - 1012
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 7
ER -