[Prognostic factors in multiple sclerosis in a population-based series in Asturias].
We sought clinical, paraclinical and genetic (HLA) factors that might have prognostic value in predicting disability produced by multiple sclerosis. An epidemiologically based sample including 146 cases (86% remittent and 14% mainly progressive) was studied. The progression of disability was measured on an index after systematic follow-up of at least 3 years. Our results show that the prognosis is significantly worse for those with a high frequency of attacks (p < 0.001), multiple clinical signs at presentation (p < 0.05) or motor weakness. The best prognosis was associated with those whose symptoms began with sensory alterations (p < 0.05). Late onset correlated significantly with a short interval between the first and second attack (r = 0.24), and this short interval was in turn significantly correlated with higher frequency of attacks in later stages (r = 0.44). We conclude that cases with a short interval between the first two attacks and those with late onset have a poorer prognosis. The following variables also tended to be associated with a more unfavorable prognosis, although the relationship was not statistically significant: female, progressive form, an increase in gammaglobulins in spinal fluid, infratentorial lesions as evidenced by magnetic resonance, and the alleles HLA-DR4, DR7 and DQw8. The allele DQw5 tended to be associated with a better prognosis.
Uría
D F
DF
Sección de Neurología, Hospital San Agustín, Aviĺes, Asturias.
Menes
B B
BB
Calatayud
M T
MT
Arribas
J M
JM
D000328:Adult; D017668:Age of Onset; D001921:Brain / Q000503:physiopathology; D005260:Female; D006684:HLA-DR Antigens / Q000276:immunology; D006239:Haplotypes; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007223:Infant; D008297:Male; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology; D011379:Prognosis; D013030:Spain / Q000453:epidemiology; D014792:Visual Acuity
D006684:HLA-DR Antigens; D007074:Immunoglobulin G
Factores pronósticos de la esclerosis múltiple en una serie de base poblacional de Asturias.