Hypogammaglobulinemia: A contributing factor to multiple sclerosis fatigue?

Diem, L; Evangelopoulos, M E; Karathanassis, D; Natsis, V; Kamber, N; Hammer, H; Friedli, C; Chan, A; Helbling, A; Penner, I K; Salmen, A; Walther, S; Stegmayer, K; Hoepner, R (2022). Hypogammaglobulinemia: A contributing factor to multiple sclerosis fatigue? Multiple Sclerosis and Related Disorders, 68, p. 104148. Elsevier 10.1016/j.msard.2022.104148

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OBJECTIVE

Fatigue is one of the most disabling and difficult to treat symptoms of autoimmune diseases and frequently presents in people with multiple sclerosis (PwMS). Hypogammaglobulinemia for immunoglobulin G (IgG) affects approximately 8-25% of PwMS. We performed a retrospective analysis to investigate the association of MS-fatigue and IgG hypogammaglobulinemia.

METHODS

PwMS, treated at Eginition University Hospital Athens or at the University Hospital Bern, were included (n = 134 patients (Bern n = 99; Athens n = 35)). Mann Whitney U-test (MWT), ANOVA test, Chi2 test and multivariable linear regression models were run.

RESULTS

97/134 (72.4%) PwMS reported fatigue. In the multivariable linear regression analysis, IgG serum concentration (-1.6, 95%CI -2.7 - -0.5, p = 0.006), daytime sleepiness (0.8, 95%CI 0.2-1.4, p = 0.009), and a depressive mood (1.1, 95%CI 0.8-1.4, p < 0.001) were significantly associated with fatigue. The impact of IgG serum concentration (-2.9 95%CI -4.7 - -1.1, p = 0.002) remained significant also in the subcohort of PwMS without depressive symptoms or daytime sleepiness.

CONCLUSIONS

We found an association between IgG hypogammaglobulinemia and fatigue in PwMS (Level of Evidence IV), which might be translated to other autoimmune diseases. It bears a potential therapeutic consequence considering IgG supplementation strategies, if our finding can be validated prospectively.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology

UniBE Contributor:

Diem, Lara, Kamber, Nicole, Hammer, Helly Noemi, Friedli, Christoph Daniel, Chan, Andrew Hao-Kuang, Helbling, Arthur, Penner, Iris-Katharina, Salmen, Anke, Walther, Sebastian, Stegmayer, Katharina Deborah Lena, Hoepner, Robert

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2211-0348

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

08 Sep 2022 09:05

Last Modified:

14 Dec 2022 00:13

Publisher DOI:

10.1016/j.msard.2022.104148

PubMed ID:

36063730

Uncontrolled Keywords:

Fatigue Immunoglobulin Multiple sclerosis

BORIS DOI:

10.48350/172724

URI:

https://boris.unibe.ch/id/eprint/172724

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