The Role of Gender in Early Onset Relapsing Remitting Multiple Sclerosis

Abstract

ABSTRACT:BACKGROUND: Multiple sclerosis is an autoimmune inflammatory demyelinating disorder of the central nervous system. Multiple sclerosis is now universally found to be more prevalent in women than menOBJECTIVE: The aim of the study is to clarify the role of gender in early onset multiple sclerosisPATIENTS AND METHODS: This retrospective study was conducted in the multiple sclerosis clinic archive system in the Medical City Hospital in Baghdad, Iraq. Data collection was carried out between March 2008 and March 2009. The patients diagnosed to have relapse remitting multiple sclerosis according to the revised McDonald’s diagnostic criteria for multiple sclerosis, and onset of disease must be before the eighteenth birthday. For each patient, the following information was gathered: age, gender, date of onset, and date of second attack, presenting symptom, and extended disability status scale and the date, and type and location of MRI lesions. A p-value <0.05 was considered the cutoff point to determine significant findings. RESULTS: Forty-eight of the patients where females (62.3%) and 29 patients where males (37.7%), with a female: male ratio 1.6:1. No significant difference was found regarding distribution of gender in each age group, and no significant difference was found when age at onset was compared between males and females, although in male patients a shift to children and a shift at adolescence in female were observed The comparison of different radiological sites between males and females shows a significant difference with more males having infratentorial lesions compared with females (P=0.033). No significant difference was found between the two genders regarding, age at onset the presenting symptom, mode of onset and no significant difference was found when interval between the first and second attack was compared between males and females. CONCLUSION: Female preponderance was highest for subjects with disease onset at adolescents. No significant difference was found when age at onset was compared between males and females, although in male patients, a shift to children and a shift at adolescence in female were observed. A significant difference in the time, between first and second attack between males and females. A significant difference in the MRI findings was the finding that males had a higher incidence of infratentorial lesion than females.