Journal of the Neurological Sciences 168 (1999) 32–36 www.elsevier.com / locate / jns Early synthesis and correlation of serum anti-thyroid antibodies with clinical parameters in multiple sclerosis a, b a a b b a * P. Annunziata , F. Lore’ , E. Venturini , P. Morana , E. Guarino , S. Borghi , G.C. Guazzi a Institute of Neurological Sciences, Viale Bracci, 2, University of Siena, 53100 Siena, Italy b Endocrinology Unit, University of Siena, Siena, Italy Received 14 December 1998; received in revised form 6 July 1999; accepted 6 July 1999 Abstract A high frequency of anti-thyroid antibodies has been demonstrated in multiple sclerosis (MS), but there is a lack of data on the possible association of thyroid autoimmunity with disease activity. To assess whether anti-thyroid antibodies are synthesized early in MS or are induced over the course of the disease and whether or not they are correlated with clinical findings, we assayed serum anti-peroxidase and anti-thyroglobulin antibodies in 129 relapsing–remitting MS patients at the time of diagnosis and prior to any immunosuppressive or immunomodulatory treatment. Anti-peroxidase antibodies were detected in 28 / 129 (21.7%) MS patients, compared to 12 / 130 (9.2%) neurological controls ( P50.006) and 8/152 (5.3%) normal healthy subjects ( P,0.0001). High titres of anti-thyroglobulin antibodies were detected in 11 / 129 (8.5%) MS patients compared to 6 / 130 (4.6%) patients with other neurological diseases ( P50.22) and 5/152 (3.3%) normal healthy subjects ( P50.07). Anti-peroxidase antibodies were associated with initial relapse in 14 of 28 (50%) of the patients compared to 18 / 101 (18%) without antibodies ( P50.001). Similarly, anti-thyroglobulin antibodies were associated with first relapse in 8/11 (73%) of the patients compared to 11/118 (9.3%) of those without ( P,0.0001). However, there was no correlation between anti-thyroid antibody titres and disease duration or CSF IgG index values. By contrast, a significant inverse correlation was found between anti-thyroglobulin antibody titres and EDSS score (r 520.75; P50.008). Our findings demonstrate that anti-peroxidase and anti- s thyroglobulin antibodies are synthesized early in relapsing–remitting MS and are associated with early clinical disease activity. Furthermore, high titres of anti-thyroglobulin antibodies are associated with low disability scores, suggesting a possible protective role of these antibodies that deserves further investigation.  1999 Elsevier Science B.V. All rights reserved. Keywords: Multiple sclerosis; Thyroid; Autoimmunity; Disability 1. Introduction been found in MS [3] without evident alteration of thyroid function. Immunomodulatory therapies, like beta-interferon The association of multiple sclerosis (MS) with non- and copolymer-1, recently introduced for MS, have fo- nervous autoimmune disorders has been the subject of cused attention on the possible development of systemic several reports [1,2], but no convincing higher prevalence autoimmunity in MS patients and a recent report described of particular autoimmune disease has been demonstrated in high titres of anti-thyroid antibodies and the development MS patients with respect to the normal population. How- of autoimmune hyperthyroidism in MS patients in the ever, a number of organ- and non-organ-specific auto- course of treatment with interferon beta-1b [4]. However, antibodies have been found in MS patients at a higher none of the studies dealing with anti-thyroid antibodies in frequency than in the general population [2]. In particular, MS patients have been focused on disease activity or a high incidence of anti-microsomal thyroid antibodies has clinical parameters [2,3]. Thus, it is of interest to assess whether auto-antibodies directed against thyroid antigens are synthesized early in MS before treatment or are *Corresponding author. Tel.: 139-577-233-482; fax: 139-577-403-27. E-mail address: annunziata@unisi.it (P. Annunziata) induced in the course of the disease. To investigate this 0022-510X / 99 / $ – see front matter  1999 Elsevier Science B.V. All rights reserved. PII: S0022-510X(99)00168-9