title: Neurological manifestations of connective tissue diseases mimicking multiple sclerosis.
abstract: The objective of the study was to analyze retrospectively the clinical, laboratory and imaging findings of multiple sclerosis (MS), such as the manifestations in a cohort of 132 patients referred to the neurology in and outpatient clinic. The proposed clinical and laboratory diagnostic criteria for MS and connective tissue disorders were systematically assessed in 132 consecutive patients. Cerebrospinal fluid serology and brain or spinal cord MRI were studied in all cases. In patients suspected for connective tissue disorder, schirmer test, rose bengal staining and biopsy of minor salivary glands were performed. A total of 115 (87%) patients were diagnosed to have definite MS, while 17 (13%) were diagnosed to have connective tissue disorder. Positive neurological and MRI findings were observed in both groups. The majority of patients with connective tissue disorder demonstrated extra-neurological manifestations like Raynaud's phenomenon, arthritis, livedo reticularis, purpura and presence of multiple autoantibodies in their sera. All patients with MS should be screened systematically for connective tissue disorder. In the absence of pathognomonic clinical and laboratory findings, the diagnosis of MS is a diagnosis of exclusion.
authors.affiliation: Department of Neurology, University of Ioannina School of Medicine, University Campus, Ioannina 45110, Greece.
authors.forename: Sigliti-Henrietta
authors.initials: SH
authors.lastname: Pelidou
authors.forename: Sotiris
authors.initials: S
authors.lastname: Giannopoulos
authors.forename: Sotiria
authors.initials: S
authors.lastname: Tzavidi
authors.forename: Niki
authors.initials: N
authors.lastname: Tsifetaki
authors.forename: Georgios
authors.initials: G
authors.lastname: Kitsos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Stefanou
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Kostadima
authors.forename: Alexandros A
authors.initials: AA
authors.lastname: Drosos
authors.forename: Athanassios P
authors.initials: AP
authors.lastname: Kyritsis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000473:pathology; D001323:Autoantibodies / Q000097:blood; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D015331:Cohort Studies; D003240:Connective Tissue Diseases / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D054068:Livedo Reticularis / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology; D011859:Radiography; D011928:Raynaud Disease / Q000473:pathology; D012698:Serologic Tests; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult
chemical_list: D001323:Autoantibodies