Symptoms Prior to Diagnosis of Multiple Sclerosis in Individuals Younger Than 18 Years
Authors' conclusion
In this population-based, matched case-control study, children and adolescents with MS had diverse metabolic, ocular, musculoskeletal, gastrointestinal, and cardiovascular symptoms, signs, or diagnoses within 5 years before their first MS diagnosis.
Study context
- Population
- Children and adolescents (aged <18 years) in Germany with statutory health insurance, January 2010 to December 2020788 (72.2%) of multiple sclerosis (MS) cases female
- Participants
- 1,091 / 10,910 / 1,068
- Comparison
- Children and adolescents with MS vs controls without MS and controls with juvenile idiopathic arthritis (JIA)
- MSn = 1,091
- Without MSn = 10,910reference
- JIAn = 1,068reference
- Outcome
- ICD-10-GM diagnoses (163 codes) in the 5 years before a first MS diagnosis, in incident cases of MS
- Follow-up
- 5 years before first MS diagnosis
Methodological detailspopulation-based, univariable and multivariable logistic regression, Data analyzed from November 2023 to April 2024
- Population-based
- Univariable and multivariable logistic regression
- Data analyzed from November 2023 to April 2024
Main finding
As reported in the abstract
ICD-10-GM codes more frequent in the 5 years before first MS diagnosis, MS vs controls without MS
Each group vs without MSEstimate (95% CI)
MS
aOR (obesity) 1.70(1.42–2.02)
MS
aOR (disorders of eye refraction and accommodation) 1.26(1.09–1.47)
MS
aOR (visual disturbances) 1.31(1.10–1.55)
MS
aOR (gastritis and duodenitis) 1.35(1.08–1.70)
MS
aOR (patella disorders) 1.47(1.13–1.90)
MS
aOR (heartbeat abnormalities) 1.94(1.27–2.96)
MS
aOR (flatulence) 1.43(1.01–2.01)
MS
aOR (skin sensation disturbances) 12.93(8.98–18.62)
MS
aOR (dizziness and giddiness) 1.52(1.22–1.89)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Diagnoses before first MS diagnosis more prevalent in MS than in JIA controls · 5 years before first MS diagnosisMSvs JIA | aOR (obesity) 3.19 (95% CI 2.03–5.02) | |
| Diagnoses before first MS diagnosis more prevalent in MS than in JIA controls · 5 years before first MS diagnosisMSvs JIA | aOR (refraction and accommodation disorders) 3.08 (95% CI 2.33–4.08) | |
| Diagnoses before first MS diagnosis more prevalent in MS than in JIA controls · 5 years before first MS diagnosisMSvs JIA | aOR (visual disturbances) 1.62 (95% CI 1.13–2.33) | |
| Diagnoses before first MS diagnosis more prevalent in MS than in JIA controls · 5 years before first MS diagnosisMSvs JIA | aOR (skin sensation disturbances) 27.70 (95% CI 6.52–117.64) | |
| 0.050.21520Ratio (log scale) |
Original publication
Symptoms Prior to Diagnosis of Multiple Sclerosis in Individuals Younger Than 18 Years. JAMA Netw Open. Published 2 December 2024. doi:10.
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