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Associated Clinical Disorders and Immunological Evaluations

Stanley H. Appel, MD; Vicki Stockton-Appel, RN; S. Scott Stewart, MD; Ronald H. Kerman, MD

Arch Neurol. 1986;43(3):234-238.

Abstract
• We examined the family history and associated diseases in 58 patients with amyotrophic lateral sclerosis (ALS), as well as the T-cell phenotypes and functions in 46 consecutive patients with this disorder. A family history of thyroid disease was present in 19%, and an additional 21% of patients described family members with other possible autoimmune disorders. In 19% of the patients with ALS either past or present thyroid disease was documented. Eleven of 47 additional patients with ALS had significant elevations of microsomal and/or thyroglobulin antibody levels. The T-cell phenotypes and functions were comparable in the ALS and control groups, with the exception of the presence of Ia antigen. In patients with ALS, 11.9% of the T cells were positive for the Ia antigen, while in both a normal control population and a non-ALS neurologic disease population, only 6.4% of T cells have this antigenic determinant. These data support involvement of autoimmune mechanisms in ALS.

Author Affiliations
From the Department of Neurology, Baylor College of Medicine, Houston (Drs Appel and Stewart and Ms Stockton-Appel); and the Department of Surgery, University of Texas Health Science Center at Houston (Dr Kerman).

Footnotes
Accepted for publication Aug 12, 1985.

Reprint requests to One Baylor Plaza, Houston, TX 77030 (Dr Appel).

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