Autoimmune disease preceding amyotrophic lateral sclerosis: an epidemiologic study.

Abstract

To study whether the risk of amyotrophic lateral sclerosis (ALS) is increased in people with prior autoimmune disease. An all-England hospital record-linkage dataset spanning 1999-2011 was used. Cohorts were constructed of people with each of a range of autoimmune diseases; the incidence of ALS in each disease cohort was compared with the incidence of ALS in a cohort of individuals without prior admission for the autoimmune disease. There were significantly more cases than expected of ALS associated with a prior diagnosis of asthma, celiac disease, younger-onset diabetes (younger than 30 years), multiple sclerosis, myasthenia gravis, myxedema, polymyositis, Sjögren syndrome, systemic lupus erythematosus, and ulcerative colitis. Autoimmune disease associations with ALS raise the possibility of shared genetic or environmental risk factors.