AU researchers discover link between minor surgery and multiple sclerosis

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A new study by researchers at Athabasca University's Centre for Nursing and Health Studies has discovered a small, but clinically important risk for developing multiple sclerosis in people who have had an appendectomy or tonsillectomy at the age of 20 years or younger. The study was published May 6, 2013 in the journal BMC Neurology.

The study authors suggest that, while the overall risk for the normal population is small, patients with a family history of MS, and who have had one or both of the surgeries before the age of 21, may want to be extra vigilant for symptoms of the disease.

“I want to be very careful to stress that we are definitely not saying that minor surgery causes multiple sclerosis,” says Dr. Shawn Fraser, the study's senior author. “There does appear to be a link in some cases, but much more study is needed before we can reach any conclusions about causality.”

Fraser says that both appendectomies and tonsillectomies are surgeries conducted in response to inflammation, which may indicate an inappropriate immune response. Since MS is an immune-mediated disease, there could be similarities in the conditions leading to tonsillitis or appendicitis.

Fraser, along with researchers Carol Lunny and Jennifer Knopp-Sihota looked at data from 33 previous case-controlled studies involving 27, 373 multiple sclerosis cases and more than 200,000 controls. They found a statistically significant association between patients who had undergone surgery for tonsillitis and appendicitis and the subsequent risk of developing MS, but only for those who were twenty years of age or younger at the time of surgery.

The study did not find any links between MS and other types of surgery. The researchers say well-designed prospective studies, pertaining to the risk for developing multiple sclerosis, ought to be conducted and should include the examination of various surgeries as risk factors.

The complete study, which was funded though AU's Academic Research Fund, can be found here.

Multiple Sclerosis is a complex immune-mediated inflammatory disease of the central nervous system affecting approximately 2 million people worldwide. It is one of the most common neurological disorders in young people, affecting more women than men.

For more information, please contact:

Dr. Shawn Fraser
Associate Professor & Program Director, MHS/MN
Faculty of Health Disciplines
Athabasca University