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This version was published on July 1, 2008
Multiple Sclerosis, Vol. 14, No. 6, 823-829 (2008)
DOI: 10.1177/1352458508088936

research-article

Autoimmune diseases in patients with multiple sclerosis and their first-degree relatives: a nationwide cohort study in Denmark

NM Nielsen

Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark, nmn{at}ssi.dk

M Frisch

Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark

K Rostgaard

Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark

J Wohlfahrt

Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark

H Hjalgrim

Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark

N Koch-Henriksen

The Danish Register of Multiple Sclerosis, National University Hospital, Copenhagen, Denmark; Department of Neurology, Aarhus University Hospital in Aalborg, Aalborg, Denmark; National Institute of Public Health, Copenhagen, Denmark

M Melbye

Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark

T Westergaard

Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark

Background

Multiple sclerosis (MS) and other autoimmune diseases might cluster. Our aim was to estimate the relative risk (RR) of other autoimmune diseases among MS patients and their first-degree relatives in a population-based cohort study.

Methods

Using the Danish Multiple Sclerosis Register, the Danish Hospital Discharge Register, and the Danish Civil Registration System, we estimated RRs for 42 different autoimmune diseases in a population-based cohort of 12 403 MS patients and 20 798 of their first-degree relatives. Ratios of observed to expected numbers of autoimmune diseases, based on national sex-, age-, and period-specific incidence rates, served as measures of the RRs.

Results

Compared with the general population, MS patients were at an increased risk of developing ulcerative colitis (RR = 2.0 (95% confidence interval (CI): 1.4–2.8), n = 29) and pemphigoid (RR = 15.4 (CI: 8.7–27.1), n = 12) but at reduced risk of rheumatoid arthritis (RR = 0.5 (CI: 0.4–0.8), n = 28) and temporal arteritis (RR = 0.5 (CI: 0.3–0.97), n = 11). First-degree relatives of MS patients were at increased risks of Crohn’s disease (RR = 1.4 (CI: 1.04–1.9), n = 44), ulcerative colitis (RR = 1.3 (CI: 0.99–1.7), n = 51), Addison’s disease (RR = 3.4 (CI: 1.3–9.0), n = 4), and polyarteritis nodosa (RR = 3.7 (CI: 1.4–10.0), n = 4).

Conclusion

Patients with MS and their first-degree relatives seem to be at an increased risk of acquiring certain other autoimmune diseases.

Key Words: MS • First-degree relatives • autoimmune diseases • nationwide cohort study


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