title: Should we systematically test patients with clinically isolated syndrome for auto-antibodies?
abstract: BACKGROUND
  Several autoimmune diseases (ADs) can mimic multiple sclerosis (MS). For this reason, testing for auto-antibodies (auto-Abs) is often included in the diagnostic work-up of patients with a clinically isolated syndrome (CIS).
  
  
  OBJECTIVE
  The purpose was to study how useful it was to systematically determine antinuclear-antibodies, anti-SSA and anti-SSB in a non-selected cohort of CIS patients, regarding the identification of other ADs that could represent an alternative diagnosis.
  
  
  METHODS
  From a prospective CIS cohort, we selected 772 patients in which auto-Ab levels were tested within the first year from CIS. Baseline characteristics of auto-Ab positive and negative patients were compared. A retrospective revision of clinical records was then performed in the auto-Ab positive patients to identify those who developed ADs during follow-up.
  
  
  RESULTS
  One or more auto-Ab were present in 29.4% of patients. Only 1.8% of patients developed other ADs during a mean follow-up of 6.6 years. In none of these cases the concurrent AD was considered the cause of the CIS. In all cases the diagnosis of the AD resulted from the development of signs and/or symptoms suggestive of each disease.
  
  
  CONCLUSIONS
  Antinuclear-antibodies, anti-SSA and anti-SSB should not be routinely determined in CIS patients but only in those presenting symptoms suggestive of other ADs.
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Negrotto
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Tur
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Tintoré
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Georgina
authors.initials: G
authors.lastname: Arrambide
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Sastre-Garriga
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Río
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Comabella
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Nos
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Galán
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Angela
authors.initials: A
authors.lastname: Vidal-Jordana
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Simon
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Castilló
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain.
authors.forename: Filipe
authors.initials: F
authors.lastname: Palavra
authors.affiliation: Radiology Department (IDI), Vall d'Hebron University Hospital, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Mitjana
authors.affiliation: Radiology Department (IDI), Vall d'Hebron University Hospital, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Auger
authors.affiliation: Radiology Department (IDI), Vall d'Hebron University Hospital, Spain.
authors.forename: Àlex
authors.initials: À
authors.lastname: Rovira
authors.affiliation: Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Spain xmontalban@cem-cat.org.
authors.forename: Xavier
authors.initials: X
authors.lastname: Montalban
mesh_terms: D000328:Adult; D000367:Age Factors; D000974:Antibodies, Antinuclear / Q000097:blood*; D003711:Demyelinating Diseases / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D012737:Sex Factors
chemical_list: D000974:Antibodies, Antinuclear; C035356:SS-A antibodies; C035357:SS-B antibodies
keywords: Multiple sclerosis; antibodies; antinuclear; autoimmune diseases; demyelination