title: Clinical profile and HLA-DRB1 genotype of late onset multiple sclerosis in Western Australia.
abstract: We aimed to characterize the clinical profile and human leukocyte antigen (HLA)-DRB1 genotype of patients with late onset multiple sclerosis (LOMS) in Western Australia. The clinical features, laboratory studies and HLA-DRB1 alleles were analysed in patients with multiple sclerosis (MS) with onset over 50years of age and compared with 100 patients with early onset MS (EOMS). Of a cohort of 829 patients with MS, 73 (8.8%) presented at over 50years of age, including 14 (1.7%) over 60years. Patients with LOMS had a lower female to male ratio, more frequent initial motor dysfunction, less frequent sensory symptoms and optic neuritis, a more frequent primary-progressive course and shorter time to reach Extended Disability Status Scale (EDSS) scores of 3.0 and 6.0. More LOMS patients were initially misdiagnosed compared to patients with EOMS. HLA-DRB1 *1501 was strongly associated with both LOMS and EOMS compared to the Control subjects, while HLA-DRB1 *0801 was over-represented in patients with LOMS. We concluded that patients with LOMS have a different clinical profile when compared to those with EOMS. Carriers of HLA-DRB1 *0801 may be more prone to develop MS at a later age.
authors.affiliation: Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, Western Australia, Australia.
authors.forename: Wei
authors.initials: W
authors.lastname: Qiu
authors.forename: Jing-Shan
authors.initials: JS
authors.lastname: Wu
authors.forename: Alison
authors.initials: A
authors.lastname: Castley
authors.forename: Ian
authors.initials: I
authors.lastname: James
authors.forename: Joyce
authors.initials: J
authors.lastname: Joseph
authors.forename: Frank T
authors.initials: FT
authors.lastname: Christiansen
authors.forename: William M
authors.initials: WM
authors.lastname: Carroll
authors.forename: Frank L
authors.initials: FL
authors.lastname: Mastaglia
authors.forename: Allan G
authors.initials: AG
authors.lastname: Kermode
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D000483:Alleles; D018450:Disease Progression; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006684:HLA-DR Antigens / Q000235:genetics*; D059811:HLA-DRB1 Chains; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000235:genetics* / Q000503:physiopathology*; D012737:Sex Factors; D018709:Statistics, Nonparametric; D014904:Western Australia
chemical_list: D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains