What question did this study set out to answer?

To report two pediatric cases of multiple autoimmune syndrome associated with pediatric-onset multiple sclerosis.

February 9, 2026Journal of Child Neurology0 citations

Pediatric-Onset Multiple Sclerosis in Multiple Autoimmune Syndrome: Reporting This Rare Entity in 2 Pediatric Patients

EBEvangelia BechlivaniAristotle University of Thessaloniki KNKonstantinos NotasAgios Pavlos General Hospital EPEfterpi PavlidouUniversity of Ioannina

Key Points

To report two pediatric cases of multiple autoimmune syndrome associated with pediatric-onset multiple sclerosis.
Described two pediatric patients meeting multiple autoimmune syndrome criteria.
Evaluated autoimmune disorders present in each patient.
Assessed immunogenetic factors, including HLA-DRB1*15:01 positivity.
Both patients exhibited multiple autoimmune disorders alongside POMS.
Shared immunogenetic markers include HLA-DRB1*15:01 positivity and vitamin D deficiency.
Both cases suggest a systemic autoimmune condition in pediatric patients.

Abstract

Multiple autoimmune syndrome (MAS) is characterized by the coexistence of 3 or more autoimmune disorders in the same individual and is exceptionally rare in childhood. Pediatric-onset multiple sclerosis (POMS) represents 3% to 5% of all multiple sclerosis (MS) cases and is increasingly recognized within the broader spectrum of immune-mediated diseases. We describe 2 pediatric patients fulfilling MAS criteria in association with POMS—one with type 1 diabetes mellitus and autoimmune thyroiditis, and another with rheumatoid arthritis and autoimmune thyroiditis. Both exhibited HLA-DRB1*15:01 positivity, Epstein-Barr virus IgG seropositivity, and severe vitamin D deficiency, suggesting shared immunogenetic and environmental risk factors. These cases highlight the potential of POMS to manifest as part of a systemic autoimmune diathesis. Early recognition, proactive screening, and multidisciplinary management are essential. Further multicenter studies and registry-based data are needed to clarify the prevalence, mechanisms, and prognostic implications of MAS in pediatric MS.

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