Evaluation of Helicobacter pylori infection and clinical features in multiple sclerosis patients coexisting with vitiligo: Case-series

Abstract

Background: Multiple Autoimmune Syndrome (MAS) involves at least three distinct autoimmune diseases. MAS' exact cause is unknown, however, genetic, immunologic, environmental, and infectious factors like Helicobacter pylori (H.pylori) are involved in its pathophysiology. Hence, in the current study, we described the demographic, and clinical characteristics of Multiple Sclerosis (MS) patients coexisting with vitiligo. Furthermore, we investigated the relationship between H. pylori eradication and patients' clinical improvement. Materials and Methods: In this case-series study, eight female MS patients with clinically confirmed vitiligo were assessed for demographic and clinical characteristics via questionnaires and medical records. H. pylori infection also was evaluated using ELISA and stool antigen (HpSag) tests, and positive cases received eradication therapy. Results: The mean onset ages for MS and vitiligo were 23.12 +/- 5.27 and 26.75 +/- 4.97 years, with disease durations of 10.4 and 6.8 years, respectively. Six patients (75) had an active vitiligo, and only one had active MS. Family history of MS and vitiligo was observed in 37.5 and 50 of patients, while 87.5 had other autoimmune diseases in their families. The mean H.pylori IgG and IgM levels were 15.58 +/- 13.63 and 0.43 +/- 0.31, respectively and H. pylori infection was detected in 25 of patients by either serology or stool antigen test, and no active vitiligo was observed post-eradication. Conclusion: Since, our findings showed a potential association between H. pylori infection and the pathophysiology of vitiligo, eradication therapy may be used as a complementary approach alongside standard vitiligo treatments or even MS in MAS patients.