An investigation of HLA-encoded genetic susceptibility to multiple sclerosis in subjects of Asian Indian and Afro-Caribbean ethnic origin

The association of multiple sclerosis (MS) with the HLA class 11 loci DR and DQ was investigated in populations of Asian Indian and Afro-Caribbean ethnic origin, resident in the United Kingdom. The putative haplotype, DRB1*1501.DQA1*0102.DQBI*0602, was weakly positively associated with MS in both races. The overall contribution to disease susceptibility of this marker was small. Over 80 percent of MS patients in both racial groups did not possess this haplotype. The data suggest that other genetic and/or environmental factors may be more important in predisposing to MS in these two races. Our study also raises the possibility that genetically distinct forms of the disease may be expressed in white Caucasian and non-Caucasian populations (AU)

Motor neuron disease and multiple sclerosis among immigrants to England from the Indian subcontinent, the Caribbean, and east and west Africa

The mortality from motor neuron disease (MND) and multiple sclerosis (MS) was studied among immigrants to England and Wales from the Indian subcontinent, the Caribbean, and East and West Africa during the 10 years 1979-88. The MND mortality among ethnic Asian males was only half and for females one fifth of that expected at English rates. MND mortality in Caribbean immigrants was somewhat lower than expected. White immigrants from the Indian subcontinent had the expected MND mortality. MS mortality was low among Asian, West Indian, and African immigrants. This study is evidence that MND mortality is not the same in all ethnic groups (AU)

Multiple scherosis, tropical spastic paraparesis and HTLV-1 infection in Afro-Caribbean patients in the United Kingdom

Forty four consecutive patients of Afro-Caribbean origin resident in the United Kingdom (UK) were studied, based on a provisional diagnosis of myelopathy of unknown cause, tropical spastic paraparesis (TSP) or multiple scherosis (MS). Of 30 patients with progressive paraparesis 27 had serum antibodies to HTLV-1 and were classified as having TSP. Fourteen patients fulfilled the criteria for MS and none of 12 tested had HTLV-1 antibodies. All the TSP patients and nine of those with MS were born in West Indies. Five of the West Indian born MS patients had migrated to the UK after adolescence but the duration of residents in the UK before symptoms of MS developed was similar to those born in the UK (average 18 years). The features that differentiated MS from TSP patients, apart from HTLV-1 status, included clinical evidence of cranial nerve involvement, more extensive abnormalities on the brain and cervical cord MRI and asymmetry of the VEP latency increase, all of which were more frequent in the MS group. Of the three patients without a diagnosis one, born in the UK, had marked abnormalities on MRI of the brain indistinguishable from those seen in MS (AU)

Multiple sclerosis in Trinidad and Tobago - abstract

No studies have been reported on the incidence or prevalence or multiple sclerosis in Trinidad and Tobago. This paper reports on 15 cases presenting between 1976 and 1986, seen either at the Port-of-Spain General Hospital (9) or privately (6) by one of us (P.R.). All the cases fit into one of the categories defined by Poster et al (1983): 3 are laboratory supported, definite; 9 are clinically definite; and 3 are clinically probable. One is an expatriate who was born and lived in Scotland for more than 30 years. Fourteen were born in the West Indies - 3 in Jamaica and 11 in Trinidad. The male: female ratio is 12:2. Of the 11 patients from Trinidad, 4 are of East Indian origin; 1 of African origin and 6 mixed (at least 1 grandparent white). Of the 3 born in Jamaica, 2 are mixed and one probably of pure African origin. The age of onset of symptoms was between 11 and 39 years. Most of the patients were diagnosed within 2 years of their first symptoms. Three died, 2 of African origin (aged 37 and 43), both 6 years after diagnosis and 1 East Indian, 4 years after diagnosis. Of the 14 West Indian born patients, 64 percent presented with visual symptoms; 78 percent had optic neuritis/atrophy during the illness. In temperate climates, the prevalence of optic neuritis is 25-40 percent. Tests for HTLV-1 antibodies were done in 8 patients; 1 case was positive. CSF from 5 patients was examined for oligoclonal banding and 3 were positive. The fact that 8 of the 14 patients are of mixed (African and White) ancestry is a point in favour of some predisposing gene from a white ancestor (AU)

Increasing prevalence of multiple sclerosis in Barbados - abstract

A review of patients diagnosed as having multiple sclerosis (MS) at the Queen Elizabeth Hospital since 1961 has been carried out. Thirty-eight of 45 cases fulfilled the agreed criteria for diagnosis. There has been an eight-fold increase in the incidence of multiple sclerosis seen at the QEH over the last 25 years, and particularly the last decade (22 or 58 percent in the last six years). The gender ratio (1.9:1), age of onset (31 ñ 6.8), the clinical spectrum and course of patients in this series are almost identical to the well-known clinical spectrum of MS. Eight patients were expatraiates - residents and tourists. One of these was made dramatically worse by the heat, perhaps equivalent to the "hot bath test". Of the 30 West Indian patients, 14 had lived overseas for one year or more and two had spent short vacations abroad, but nine had never left Barbados. The greatly increased rate of diagnosis of MS may reflect increased risk through travel - emigration and return, study travel, holiday travel and tourism - as well as improved referral diagnostic practices. Local physicians, therefore, need to be more aware of the possibility of MS in the Caribbean, and its protean forms. A continiung and significant further increase in new cases is predicted (AU)

Antibody to human T-lymphotropic virus type 1 in West-Indian-born UK residents with spastic paraparesis

Of 13 West-Indian-born UK residents with spastic paraparesis of unknown cause, 11 were tested for serum antibody to human T-cell lymphotropic virus type 1 and all were positive. Their magnetic resonance imaging scans were normal or showed only minor abnormalities in the brain, and the spinal cord was normal in the 5 investigated. Of 48 patients with multiple sclerosis, mainly caucasian, none had antibody to HTLV-1 in the blood.(AU)

Demyelinating disease in a woman from tropical South America with features of multiple sclerosis and neuromyelitis opticaz: clinical, protein chemistry and pathological findings

The ocurrence of demyelinating disease with many of multiple sclerosis and of neuromyelitis optica in a patient born and brought up in Guyana in tropical South America is so exceptional as to merit an individual case report. The similarities and differences between the findings in this patient and those accepted as typical of these diseases, as they are commonly known, are discussed in detail. (AU)

Multiple sclerosis in Jamaica

Four cases of clinical multiple scelerosis are described in indegenous Jamaicans, three of whom had never left the Island. Three were in the higher social grades and two were Negro. The course of the disease resembled that in temperate countries. A survey of other neurological cases among 10,000 in-patients and 1,500 autopsies reveal no evidence of syndromes which could be attributed to multiple sclerosis in an unusual form. It is concluded that multiple sclerosis in indigenous Jamaicans is extremely rare, but shows no unusual features