A Culprit to Consider in Multiple Sclerosis?

Laurie L. Barclay, MD


April 16, 2012

Low Serum Vitamin D Levels and Recurrent Inflammatory Spinal Cord Disease

Mealy MA, Newsome S, Greenberg BM, Wingerchuk D, Calabresi P, Levy M
Arch Neurol. 2012;69:352-356

Study Summary

Vitamin D is a sterol hormone implicated in several immunologic pathways, and therefore it may help to prevent isolated immune-mediated central nervous system attacks from developing into recurrent disease. Low levels of 25-hydroxyvitamin D have been linked to greater risk for multiple sclerosis (MS) and higher relapse rates in patients with MS. The goal of this retrospective analysis was to evaluate the association between low serum levels of vitamin D and recurrent spinal cord disease.

Investigators at Johns Hopkins Transverse Myelitis Center in Baltimore, Maryland, measured 25-hydroxyvitamin D levels in 77 patients who had monophasic and recurrent inflammatory diseases of the spinal cord. After adjustment for season, age, sex, and race, patients who developed recurrent spinal cord disease had significantly lower vitamin D levels.


Study limitations include retrospective design, small sample size, and failure to account for some covariates of vitamin D. In addition, vitamin D levels were not obtained at the same time in the disease state for each patient. Nonetheless, the findings suggest a possible association between lower total 25-hydroxyvitamin D levels in patients with recurrent inflammatory spinal cord disease compared with patients who have monophasic disease. The findings from this study justify conducting a prospective trial to measure 25-hydroxyvitamin D levels in these patient populations and determine the effect of vitamin D supplementation on the frequency of relapses in patients with recurrent inflammatory spinal cord disease.



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