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Occurrence of CCSVI in patients with MS and its relationship with iron metabolism and varicose veins
Author(s) -
Van den Berg P. J.,
Van den Berg G. B.,
Westerhuis L. W.,
Visser L. H.
Publication year - 2013
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12010
Subject(s) - medicine , multiple sclerosis , expanded disability status scale , gastroenterology , odds ratio , varicose veins , surgery , immunology
Background and purpose A new treatable venous disorder, chronic cerebrospinal venous insufficiency ( CCSVI ), has been proposed in patients with multiple sclerosis ( MS ). Its relationship with iron metabolism is suggested, but has not been examined prospectively. Methods We performed extra‐ and transcranial echo colour D oppler ( ECD ) in 90 patients with MS and 41 healthy controls ( HC ). Indices of iron metabolism and the presence of peripheral signs of impaired venous flow were also examined. Results The ECD examination showed CCSVI in 8 (9%) of the 90 patients with MS and 0 HC ( P = 0.11). The 8 CCSVI ‐positive MS patients were older ( P = 0.02), had less often relapsing–remitting‐ MS ( P = 0.02) and had more neurological disability assessed by expanded disability status scale ( EDSS , P = 0.001) and longer duration of disease ( P = 0.02) in comparison with the 82 CCSVI ‐negative MS patients. Multivariate analysis revealed that EDSS remained an independent factor associated with CCSVI (odds ratio 1.89, 95% CI 1.17–3.05, P ‐value = 0.009). CCSVI MS patients more often had bilateral telangiectasia at the legs ( P = 0.008), reticular veins ( P = 0.006) and venous stasis dermatitis ( P = 0.004). No relationship was found between CCSVI and impaired iron metabolism in patients with MS . Conclusions CCSVI is uncommon and is a secondary epiphenomenon in MS and related to more neurological disability and the presence of varicose veins at the legs.