The MRZ reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosis
Abstract Background Some rheumatologic disorders may initially manifest with central nervous system (CNS) affection, mimicking the clinical, magnetic resonance imaging, and cerebrospinal fluid findings of multiple sclerosis (MS). The MRZ reaction (MRZR), composed of the three respective antibody ind...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | BMC Neurology |
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| Online Access: | http://link.springer.com/article/10.1186/s12883-018-1018-3 |
| _version_ | 1819113865824174080 |
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| author | Tilman Hottenrott Rick Dersch Benjamin Berger Dominique Endres Daniela Huzly Jens Thiel Sebastian Rauer Oliver Stich Ulrich Salzer Nils Venhoff |
| author_facet | Tilman Hottenrott Rick Dersch Benjamin Berger Dominique Endres Daniela Huzly Jens Thiel Sebastian Rauer Oliver Stich Ulrich Salzer Nils Venhoff |
| author_sort | Tilman Hottenrott |
| collection | DOAJ |
| description | Abstract Background Some rheumatologic disorders may initially manifest with central nervous system (CNS) affection, mimicking the clinical, magnetic resonance imaging, and cerebrospinal fluid findings of multiple sclerosis (MS). The MRZ reaction (MRZR), composed of the three respective antibody indices (AIs) against measles, rubella, and varicella zoster virus, has been found positive frequently in MS patients. However, it is unclear whether the MRZR is helpful to distinguish rheumatologic disorders with CNS involvement (RDwCNS) from MS. Methods The MRZR was evaluated in patients with RDwCNS (n = 23), MS (n = 46; age and sex matched to patients with RDwCNS), and other inflammatory autoimmune neurological diseases affecting the CNS (OIND; n = 48). Both the stringency levels that have been used in previous MRZR studies, MRZR-1 (≥ 1 of 3 AIs positive) and MRZR-2 (≥ 2 of 3 AIs positive), were applied. Results There was no statistically significant difference in the prevalence of positive MRZR between patients with RDwCNS (MRZR-1: 13.0% and MRZR-2: 8.7%, respectively) and OIND (MRZR-1: 22.9% and MRZR-2: 8.3%, respectively). Compared to these two study cohorts, the MS group exhibited significantly higher prevalences of positive MRZR (MRZR-1: 82.6%, MRZR-2: 63.0%; p < 0.005 each). Conclusions Considering the high specificity of MRZR-2 for MS found in this study, MRZR-2 can be a useful diagnostic tool for distinguishing MS from RDwCNS or OIND. |
| first_indexed | 2024-12-22T04:36:12Z |
| format | Article |
| id | doaj.art-93519b9ac11c4aeeb10f314d65dfe5d8 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-22T04:36:12Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-93519b9ac11c4aeeb10f314d65dfe5d82022-12-21T18:38:53ZengBMCBMC Neurology1471-23772018-01-011811910.1186/s12883-018-1018-3The MRZ reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosisTilman Hottenrott0Rick Dersch1Benjamin Berger2Dominique Endres3Daniela Huzly4Jens Thiel5Sebastian Rauer6Oliver Stich7Ulrich Salzer8Nils Venhoff9Department of Neurology and Neurophysiology, Faculty of Medicine, Medical Center – University of FreiburgDepartment of Neurology and Neurophysiology, Faculty of Medicine, Medical Center – University of FreiburgDepartment of Neurology and Neurophysiology, Faculty of Medicine, Medical Center – University of FreiburgDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of FreiburgInstitute of Virology, University Medical Center FreiburgDepartment of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center – University of FreiburgDepartment of Neurology and Neurophysiology, Faculty of Medicine, Medical Center – University of FreiburgDepartment of Neurology and Neurophysiology, Faculty of Medicine, Medical Center – University of FreiburgDepartment of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center – University of FreiburgDepartment of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center – University of FreiburgAbstract Background Some rheumatologic disorders may initially manifest with central nervous system (CNS) affection, mimicking the clinical, magnetic resonance imaging, and cerebrospinal fluid findings of multiple sclerosis (MS). The MRZ reaction (MRZR), composed of the three respective antibody indices (AIs) against measles, rubella, and varicella zoster virus, has been found positive frequently in MS patients. However, it is unclear whether the MRZR is helpful to distinguish rheumatologic disorders with CNS involvement (RDwCNS) from MS. Methods The MRZR was evaluated in patients with RDwCNS (n = 23), MS (n = 46; age and sex matched to patients with RDwCNS), and other inflammatory autoimmune neurological diseases affecting the CNS (OIND; n = 48). Both the stringency levels that have been used in previous MRZR studies, MRZR-1 (≥ 1 of 3 AIs positive) and MRZR-2 (≥ 2 of 3 AIs positive), were applied. Results There was no statistically significant difference in the prevalence of positive MRZR between patients with RDwCNS (MRZR-1: 13.0% and MRZR-2: 8.7%, respectively) and OIND (MRZR-1: 22.9% and MRZR-2: 8.3%, respectively). Compared to these two study cohorts, the MS group exhibited significantly higher prevalences of positive MRZR (MRZR-1: 82.6%, MRZR-2: 63.0%; p < 0.005 each). Conclusions Considering the high specificity of MRZR-2 for MS found in this study, MRZR-2 can be a useful diagnostic tool for distinguishing MS from RDwCNS or OIND.http://link.springer.com/article/10.1186/s12883-018-1018-3Neuropsychiatric systemic lupus erythematosus (NPSLE)ANCA-associated vasculitidesBehçet’s diseaseMultiple sclerosis (MS)Intrathecal polyspecific antiviral immune responseMRZ reaction (MRZR) |
| spellingShingle | Tilman Hottenrott Rick Dersch Benjamin Berger Dominique Endres Daniela Huzly Jens Thiel Sebastian Rauer Oliver Stich Ulrich Salzer Nils Venhoff The MRZ reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosis BMC Neurology Neuropsychiatric systemic lupus erythematosus (NPSLE) ANCA-associated vasculitides Behçet’s disease Multiple sclerosis (MS) Intrathecal polyspecific antiviral immune response MRZ reaction (MRZR) |
| title | The MRZ reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosis |
| title_full | The MRZ reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosis |
| title_fullStr | The MRZ reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosis |
| title_full_unstemmed | The MRZ reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosis |
| title_short | The MRZ reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosis |
| title_sort | mrz reaction helps to distinguish rheumatologic disorders with central nervous involvement from multiple sclerosis |
| topic | Neuropsychiatric systemic lupus erythematosus (NPSLE) ANCA-associated vasculitides Behçet’s disease Multiple sclerosis (MS) Intrathecal polyspecific antiviral immune response MRZ reaction (MRZR) |
| url | http://link.springer.com/article/10.1186/s12883-018-1018-3 |
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