title: Normal CSF ferritin levels in MS suggest against etiologic role of chronic venous insufficiency.
abstract: OBJECTIVE
  Chronic cerebrospinal venous insufficiency (CCSVI) has been suggested to be a possible cause of multiple sclerosis (MS). If the presumed mechanism of venous stasis-related parenchymal iron deposition and neurodegeneration were true, then upregulation of intrathecal iron transport proteins may be expected.
  
  
  METHODS
  This was a cross-sectional (n = 1,408) and longitudinal (n = 29) study on CSF ferritin levels in patients with MS and a range of neurologic disorders.
  
  
  RESULTS
  Pathologic (>12 ng/mL) CSF ferritin levels were observed in 4% of the control patients (median 4 ng/mL), 91% of patients with superficial siderosis (75 ng/mL), 73% of patients with a subarachnoid hemorrhage (59 ng/mL), 10% of patients with relapsing-remitting MS (5 ng/mL), 11% of patients with primary progressive MS (6 ng/mL), 23% of patients with secondary progressive MS (5 ng/mL), and 23% of patients with meningoencephalitis (5 ng/mL). In MS, there was no significant change of CSF ferritin levels over the 3-year follow-up period.
  
  
  CONCLUSIONS
  These data do not support an etiologic role for CCSVI-related parenchymal iron deposition in MS.
authors.affiliation: Department of Neuroimmunology, UCL Institute of Neurology, University College London, Queen Square, London, UK.
authors.forename: V
authors.initials: V
authors.lastname: Worthington
authors.forename: J
authors.initials: J
authors.lastname: Killestein
authors.forename: M J
authors.initials: MJ
authors.lastname: Eikelenboom
authors.forename: C E
authors.initials: CE
authors.lastname: Teunissen
authors.forename: F
authors.initials: F
authors.lastname: Barkhof
authors.forename: C H
authors.initials: CH
authors.lastname: Polman
authors.forename: B M J
authors.initials: BM
authors.lastname: Uitdehaag
authors.forename: A
authors.initials: A
authors.lastname: Petzold
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005293:Ferritins / Q000134:cerebrospinal fluid*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid*; D013223:Statistics as Topic; D014689:Venous Insufficiency / Q000175:diagnosis / Q000209:etiology*
chemical_list: D005293:Ferritins