Normal CSF ferritin levels in MS suggest against etiologic role of chronic venous insufficiency
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Abstract
Objectives: Chronic cerebrospinal venous insufficiency (CCSVI) has been suggested to be a possible cause of multiple sclerosis (MS). If the presumed mechanism of venous stasis–related parenchymal iron deposition and neurodegeneration were true, then upregulation of intrathecal iron transport proteins may be expected.
Methods: This was a cross-sectional (n = 1,408) and longitudinal (n = 29) study on CSF ferritin levels in patients with MS and a range of neurologic disorders.
Results: Pathologic (>12 ng/mL) CSF ferritin levels were observed in 4% of the control patients (median 4 ng/mL), 91% of patients with superficial siderosis (75 ng/mL), 73% of patients with a subarachnoid hemorrhage (59 ng/mL), 10% of patients with relapsing-remitting MS (5 ng/mL), 11% of patients with primary progressive MS (6 ng/mL), 23% of patients with secondary progressive MS (5 ng/mL), and 23% of patients with meningoencephalitis (5 ng/mL). In MS, there was no significant change of CSF ferritin levels over the 3-year follow-up period.
Conclusion: These data do not support an etiologic role for CCSVI-related parenchymal iron deposition in MS.
Footnotes
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Study funding: Supported by the Dutch Foundation of Multiple Sclerosis Research (J.E.).
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- 9HPT
- 9-hole PEG test
- AI
- ambulation index
- CCSVI
- chronic cerebrospinal venous insufficiency
- CV
- coefficient of variation
- EDSS
- Expanded Disability Status Scale score
- IQR
- interquartile range
- ME
- meningoencephalitis
- MS
- multiple sclerosis
- PPMS
- primary progressive multiple sclerosis
- RRMS
- relapsing-remitting multiple sclerosis
- SAH
- subarachnoid hemorrhage
- SPMS
- secondary progressive multiple sclerosis
- T1LV
- T1 lesion volume
- T2LV
- T2 lesion volume
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Editorial, page 1581.
- Received April 9, 2010.
- Accepted June 21, 2010.
- Copyright © 2010 by AAN Enterprises, Inc.
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Letters: Rapid online correspondence
- Normal CSF ferritin levels in MS suggest against etiologic role of chronic venous insufficiency
- Michael R. Haupts, Director, Augustahospital Anholt, Augustastr. 8, D 46419 Isselburg-Anholt, Germanymichael.haupts@ruhr-uni-bochum.de
- Meyer-Schwickerath R, Hacker A, Haug C, Fink F, Seidel D, Hartung HP
Submitted February 17, 2011 - Reply from the Authors
- Axel Petzold, Free University Medical Center, MS Center Amsterdam, Amsterdam, the Netherlandsa.petzold@ion.ucl.ac.uk
- F. Barkhof, C. Polman
Submitted February 17, 2011 - Normal CSF ferritin levels in MS suggest against etiologic role of chronic venous insufficiency
- Steven R Brenner, Neurolgist, St. Louis VA Medical Center and St. Louis University Dept. of Neurology and Psychiatry.SBren20979@aol.com
- None
Submitted January 19, 2011 - Normal CSF ferritin levels in MS suggest against etiologic role of chronic venous insufficiency
- Armando Sena, Faculty of Medical Sciences, Capuchos Hospital and CiiEM, Lisbon and Monte de Caparica, Portugalarmando.sena@fcm.unl.pt
- Rui Pedrosa, Veronique Ferret-Sena
Submitted January 19, 2011 - Reply from the authors
- Axel Petzold, UCL Institute of Neurology, Queen Square, London, UKa.petzold@ion.ucl.ac.uk
- Viki Worthington (v.worthington@ion.ucl.ac.uk)
Submitted January 19, 2011
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