Sex hormone patterns in women with multiple sclerosis as related to disease activity--a pilot study.
OBJECTIVE
The influence of sex hormones on immune system activity in multiple sclerosis (MS) has been suggested by clinical evidence. The aim of the study was to ana-lyse the pattern of sex hormones in MS women and to correlate the hormone pattern abnormalities to the disease course as well as to the magnetic resonance imaging (MRI) results.


METHODS
We studied the serum level of the progesterone, β-oestradiol and prolactin in 46 women with clinical definite MS aged from 19 to 65; mean disease duration was 11.80 ± 9.86 years. The evaluation of the intensity of hormonal changes was done using a scoring system (0-3). On the brain MRI, the presence of brain atrophy, of hypothalamic demyelination as well as demyelination intensity (or degree) were analysed. The evaluation of the degree of demyelination and brain atrophy was done using a scoring system (0-4).


RESULTS
The main hormonal abnormalities consisted of decreased progesterone level, increased oestradiol level or both. The sex hormone pattern was abnormal in 56% of patients. Hypothalamic lesions were found on MRI in 53% of cases. The abnormal hormonal pattern correlated with intensity of MR changes (p < 0.05, Fisher's exact test), but neither with presence of hypothalamic changes nor with disease parameters (Expanded Disability Status Scale, relapse rate, disease duration).


CONCLUSIONS
It is important to check the hormonal pattern in MS women because according to our results it may be related to the disease activity and probably affects the type of therapeutic intervention. This pilot study will be extended in a larger population.
Department of Neurology, The Medical University of Warsaw, Poland. Electronic address: beata.zakrzewska-pniewska@wum.edu.pl.
Beata
B
Zakrzewska-Pniewska
Department of Radiology, The Medical University of Warsaw, Poland.
Marek
M
Gołębiowski
Department of Neurology, The Medical University of Warsaw, Poland.
Małgorzata
M
Zajda
Department of Radiology, The Medical University of Warsaw, Poland.
Wojciech
W
Szeszkowski
Department of Neurology, The Medical University of Warsaw, Poland.
Aleksandra
A
Podlecka-Piętowska
Department of Neurology, The Medical University of Warsaw, Poland.
Monika
M
Nojszewska
D000328:Adult; D004185:Disability Evaluation; D018450:Disease Progression; D004958:Estradiol / Q000097:blood*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood* / Q000473:pathology*; D010865:Pilot Projects; D011044:Poland; D011374:Progesterone / Q000097:blood*; D011388:Prolactin / Q000097:blood*; D055815:Young Adult
D012739:Gonadal Steroid Hormones; D011374:Progesterone; D004958:Estradiol; D011388:Prolactin