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Epidemiology of multiple sclerosis in the pediatric population of Sardinia, Italy

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Abstract

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). Several authors report MS affecting not only young adults but also children and adolescents. Sardinia is one of the regions at the highest risk for MS worldwide in the adult population; to date, no definite data exist on the pediatric population. The aim of this study was to estimate the incidence and prevalence of pediatric MS (pMS) in northern Sardinia. Patients with diagnosis of optic neuritis, myelitis, acute disseminated encephalomyelitis (ADEM), demyelinating disorders, MS, or clinically isolated syndrome (CIS) according to McDonald criteria were enrolled, when disease onset occurred within the range of 0–18 years. From January 1, 2001 to December 31, 2012, 21 cases of pMS and 5 cases of CIS were found in northern Sardinia. The annual mean pMS incidence was 2.85 cases per 100,000 pediatric population, and the annual mean CIS incidence was 0.68 cases per 100,000 pediatric population. The pMS and CIS prevalence computed on 31 December 2012 was 26.92 and 6.41 per 100,000 pediatric population, respectively.

Conclusion: Our pMS data among Sardinians corroborate the epidemiological scenario described in the adult population being the incidence estimates significantly higher than those reported elsewhere.

What is Known:

• Sardinia is one of the regions at the highest risk for MS worldwide in the adult population.

• To date, no definite data exist on the pediatric population.

What is New:

• The pediatric MS incidence in Sardinia is estimated to be significantly higher than those reported elsewhere.

• The pediatric MS prevalence in Sardinia is among the highest values worldwide.

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Abbreviations

ADEM:

Acute disseminated encephalomyelitis

CI:

Confidence intervals

CIS:

Clinically isolated syndrome

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

IPMSSG:

International Pediatrics Multiple Sclerosis Study Group

MRI:

Magnetic resonance imaging

MS:

Multiple sclerosis

NMO:

Neuromyelitis optica

pMS:

Pediatric multiple sclerosis

RR:

Relapsing-remitting

SD:

Standard deviation

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Acknowledgments

The Authors wish to thank Dr. Francesco Zoroddu, Dr. Stefania Leoni, and Prof. Maura Pugliatti (Department of Clinical and Experimental Medicine, University of Sassari, Italy); Dr. Alessandra Sanna (Stroke Unit, ASL n. 1, Sassari, Italy); and Dr Antonio Pinna (Department of Surgical, Microsurgical, and Medical Sciences, Section of Ophthalmology, University of Sassari, Italy) for their helpful information on case collection.

S.S. wishes to address his everlasting gratitude to his mentor Prof. Giulio Rosati (retired) for 25 years of inspiration and guidance.

Compliance with ethical standards

ᅟ

Funding

None.

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

For this type of study, formal consent is not required.

Authors’ contributions

All authors have made a substantial contribution to the study conception and design and critical reviewing of the manuscript. DAS, MAS, and MS performed the literature search and quality assessment; DAS, MAS, MS, and GS have drafted the manuscript; GS performed the statistical analysis and analyzed the data; GS and SS interpreted the data; and SS made critical revision of the manuscript for important intellectual content. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Section of Child Neuropsychiatry, University of Sassari, Sassari, Italy

    Silvia Dell’Avvento & Stefano Sotgiu

  2. Department of Biomedical Sciences, Human Anatomy, University of Sassari, Sassari, Italy

    Maria Alessandra Sotgiu

  3. Unit of Neuropsychiatry for Infants and Adolescents (UONPIA), ASL 1, Sassari, Italy

    Salvatorica Manca

  4. Department of Biomedical Sciences, Clinical Epidemiology and Medical Statistics Unit, University of Sassari, Sassari, Italy

    Giovanni Sotgiu

  5. Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy

    Giovanni Sotgiu

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  1. Silvia Dell’Avvento
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  2. Maria Alessandra Sotgiu
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  3. Salvatorica Manca
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  4. Giovanni Sotgiu
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Correspondence to Maria Alessandra Sotgiu.

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Communicated by Peter de Winter

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Dell’Avvento, S., Sotgiu, M.A., Manca, S. et al. Epidemiology of multiple sclerosis in the pediatric population of Sardinia, Italy. Eur J Pediatr 175, 19–29 (2016). https://doi.org/10.1007/s00431-015-2588-3

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  • DOI: https://doi.org/10.1007/s00431-015-2588-3

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