Hypogammaglobulinemia: A contributing factor to multiple sclerosis fatigue?

L. Diem, M. E. Evangelopoulos, D. Karathanassis, V. Natsis, N. Kamber, H. Hammer, C. Friedli, A. Chan, A. Helbling, I. K. Penner, A. Salmen, S. Walther, K. Stegmayer, R. Hoepner

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objective: Fatigue is one of the most disabling and difficult to treat symptoms of autoimmune diseases and frequently presents in people with multiple sclerosis (PwMS). Hypogammaglobulinemia for immunoglobulin G (IgG) affects approximately 8–25% of PwMS. We performed a retrospective analysis to investigate the association of MS-fatigue and IgG hypogammaglobulinemia. Methods: PwMS, treated at Eginition University Hospital Athens or at the University Hospital Bern, were included (n = 134 patients (Bern n = 99; Athens n = 35)). Mann Whitney U-test (MWT), ANOVA test, Chi2 test and multivariable linear regression models were run. Results: 97/134 (72.4%) PwMS reported fatigue. In the multivariable linear regression analysis, IgG serum concentration (–1.6, 95%CI –2.7 - –0.5, p = 0.006), daytime sleepiness (0.8, 95%CI 0.2–1.4, p = 0.009), and a depressive mood (1.1, 95%CI 0.8–1.4, p < 0.001) were significantly associated with fatigue. The impact of IgG serum concentration (-2.9 95%CI -4.7 - -1.1, p = 0.002) remained significant also in the subcohort of PwMS without depressive symptoms or daytime sleepiness. Conclusions: We found an association between IgG hypogammaglobulinemia and fatigue in PwMS (Level of Evidence IV), which might be translated to other autoimmune diseases. It bears a potential therapeutic consequence considering IgG supplementation strategies, if our finding can be validated prospectively.

Original languageEnglish
Article number104148
JournalMultiple Sclerosis and Related Disorders
Volume68
DOIs
StatePublished - Dec 2022
Externally publishedYes

Keywords

  • Fatigue
  • Immunoglobulin
  • Multiple sclerosis

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