Comorbidities in multiple sclerosis
More details
Hide details
The Medicall Health Institute in Piotrków Trybunalski
The Hospital in Bełchatów
Emilia Justyna Hercuń   

The Medicall Health Institute in Piotrków Trybunalski, ul. Wojska Polskiego 77, 97-300 Piotrków Trybunalski
Ann. Acad. Med. Siles. 2019;73:243–254
Multiple Sclerosis (MS) is a chronic, inflammatory, demyelinating disease of the central nervous system, in which multifocal nerve tissue damage occurs.

Material and methods:
The study analyzed the documentation of 130 patients hospitalized for multiple sclerosis in the Neurological Department of the Hospital in Bełchatów between I.2010 and V.2018. The control group were 177 patients from the Occupational Medicine Outpatient Clinic of the Medicall Health Institute in Piotrków Trybunalski consulted in 2018.

Among patients with MS 49.2% were diagnosed with other diseases. The highest rate of comorbidity occurred in the primary progressive form and the lowest in the relapsing-remitting form. The most common diseases among MS patients were: arterial hypertension (23.8%), depression (9.2%), benign prostatic hyperplasia (7.7%), type 2 diabetes (6.9%), spinal discopathy (5.4%), cancer in anamnesis (3.8%) – 2% were malignant tumors and 2% non-malignant tumors, ischemic heart disease (3.1%), hypothyroidism (3.1%), psoriasis (3.1%), bronchial asthma (3.1%), ulcerative colitis (3.1%). Hyperlipidemia, which occurred in 35% of the subjects, was an important problem in patients with MS consisted, in the majority of cases, of elevated total and LDL cholesterol values.

The most frequent comorbidities in MS patients are hyperlipidemia, hypertension, depression, benign prostatic hyperplasia, type 2 diabetes and spinal discopathy. The distribution of disease differed in individual forms of MS, however, this could be due to the age differences among patients. Researching the issue of comorbidity in MS is an important part of the integrated care as it can improve the treatment effectiveness in this group of patients.

Giovannoni G., Butzkueven H., Dhib-Jalbut S., Hobartd J., Kobelte G., Pepperf G., Sormanig M.P., Thalheimh C., Traboulsee A., Vollmerj T. Brain health: time matters in multiple sclerosis. Multiple Sclerosis and Related Disorders 2016; 9(Suppl. 1): S5–S48, doi: 10.1016/j.msard.2016.07.003.
Bartosik-Psujek H. Stwardnienie rozsiane. Neurologia. Red. A. Stępień. Medical Tribune Polska. Warszawa 2015; s. 84–88.
Sbardella E., Tona F., Petsas N., Pantano P. DTI measurements in multiple sclerosis; evaluation of brain da mage and clinical implications. Mult. Scler. Int. 2013; 2013: 671–730, doi: 10.1155/2013/671730.
Multiple Sclerosis International Federation. 2013a. Atlas of MS 2013: Mapping Multiple Sclerosis around the World. Multiple Sclerosis International Federation. [dostęp: ].
Edwards N.C., Munsell M., Menzin J., Phillips A.L. Comorbidity in US patients with multiple sclerosis. Patient Relat Outcome Meas. 2018; 9: 97–102, doi: 10.2147/PROM.S148387.
Sicras-Mainar A., Ruiz-Beato E., Navarro-Artieda R., Maurino J. Comorbidity and metabolic syndrome in patients with multiple sclerosis from Asturias and Catalonia, Spain. BMC Neurol. 2017; 17(1): 134, doi: 10.1186/s12883-017-0914-2.
Puz P., Lasek-Bal A., Steposz A., Bartoszek K., Radecka P. Effect of comorbidities on the course of multiple sclerosis. Clin. Neurol. Neurosurg. 2018; 167: 76–81, doi: 10.1016/j.clineuro.2018.02.014.
Kowalec K., McKay K.A., Patten S.B., Fisk J.D., Evans C., Tremlett H., Marrie R.A. Comorbidity increases the risk of relapse in multiple sclerosis: A prospective study. Neurology 2017; 89(24): 2455–2461, doi: 10.1212/WNL.0000000000004716.
Marrie R.A., Walld R., Bolton J.M., Sareen J., Patten S.B., Singer A., Lix L.M., Hitchon C.A., El-Gabalawy R., Katz A., Fisk J.D., Bernstein C.N. Psychiatric comorbidity increases mortality in immune-mediated inflammatory diseases. Gen. Hosp. Psychiatry 2018; 53: 65–72, doi: 10.1016/j.genhosppsych.2018.06.001.
Tettey P., Simpson S. Jr, Taylor B.V., van der Mei I.A. Vascular comorbidities in the onset and progression of multiple sclerosis. J. Neurol. Sci. 2014; 347(1–2): 23–33, doi: 10.1016/j.jns.2014.10.020.
Salter A., Thomas NP., Tyry T. Cutter GR., Marrie RA. A contemporary profile of primary progressive multiple sclerosis participants from the NARCOMS Registry. Mult. Scler. 2018; 24(7): 951–962, doi: 10.1177/1352458517711274.
Kyritsis A.P., Boussios S., Pavlidis N. Cancer specific risk in muliple sclerosis patients. Crit. Rev. Oncol. Hematol. 2016; 98: 29–34, doi: 10.1016/j.critrevonc.2015.10.002.
Lebrun C., Rocher F. Cancer Risk in Patients with Multiple Sclerosis: Potential Impact of Disease-Modifying Drugs. CNS Drugs. 2018; 32(10): 939–949, doi: 10.1007/s40263-018-0564-y.
Drevelegas A., Xinou E., Karacostas D., Parissis D., Karkavelas G., Milonas I. Meningoma growth and interferon beta-1b treated multiple sclerosis: coincidence or relationship? Neuroradiology 2005; 47(7): 516–519, doi: 10.1007/s00234-005-1392-6.
Batay F., Al-Mefty O. Growth dynamics of meningomas in patients with multiple sclerosis treated with interferon: report of two cases. Acta Neurochir. (Wien). 2002; 144(4): 365–368, doi: 10.1007/s007010200050.
Galloway L., Vakili N., Spears J. Spontaneous regression of parafalcine meningoma in a multiple sclerosis patient being treated with interferon beta-1a. Acta Neurochir. (Wien). 2017; 159(3): 469–471, doi: 10.1007/s00701-016-3019-6.
Almeida L., Neves M., Cardoso E., Melo A. Chronic myeloid leukaemia in two multiple sclerosis patients on interferon beta-1a. J. Clin. Pharm. Ther. 2009; 34(1): 125–127, doi: 10.1111/j.1365-2710.2008.00983.x.
Schürks M., Bussfeld P. Multiple sclerosis and restless legs syndrome: a systematic review and meta-analysis. Eur. J. Neurol. 2013; 20(4): 605–615, doi: 10.1111/j.1468-1331.2012.03873.x.
Guus Schrijvers. Integrated Care. Better and Cheaper. Reed Business Information. Amsterdam 2016, 27–28.