Home About us Editorial board Ahead of print Browse Articles Search Submit article Instructions Subscribe Contacts Login 
  • Users Online: 350
  • Home
  • Print this page
  • Email this page


 
Previous article Browse articles Next article 
LETTER TO EDITOR
J Res Med Sci 2017,  22:9

The relation between genital wart and multiple sclerosis


1 Skin Diseases and Leishmaniasis Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
2 Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
3 Skin Diseases and Leishmaniasis Research Centre, Isfahan University of Medical Sciences; Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Web Publication27-Jan-2017

Correspondence Address:
Seyed Hossein Hejazi
Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan
Iran
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1735-1995.199097

Rights and Permissions

How to cite this article:
Aghaei M, Nilforoushzadeh MA, Azami M, Hejazi SH. The relation between genital wart and multiple sclerosis. J Res Med Sci 2017;22:9

How to cite this URL:
Aghaei M, Nilforoushzadeh MA, Azami M, Hejazi SH. The relation between genital wart and multiple sclerosis. J Res Med Sci [serial online] 2017 [cited 2020 Dec 2];22:9. Available from: https://www.jmsjournal.net/text.asp?2017/22/1/9/199097

Sir,

Human papillomavirus (HPV) is a contagious virus which is transmitted via sexual contact and cause genital warts in both genders. Infection persists for months and as a skin disease has a relationship with the prevalence of psychological disorders.[1],[2]

Multiple sclerosis (MS) is chronic inflammation of central nervous system. Cause of MS is unknown, but hypotheses have proposed possible roles of viral agents and vaccines in its pathogenesis, as studies have shown that viral infections are short-term risk factors for MS onset or relapses to occur in established MS.[3] Because of host's hormonal or cellular immune response is responsible for the progression of HPV and hence MS and both are more common in early to middle adulthood of females, we studied two woman patients for searching this relation.[1],[3] Case-1 was a 25-year-old married woman from Iran that experienced genital wart after marriage. After confirming HPV infection by Pap smear test and curing with podophyllin, she afflicted to clinically isolated syndrome with symptoms such as left side numbness of the body after 4 months. Her personal history was significant for sever measles as a child, and strict chicken pox later in school but she had not medical history of MS among her first-degree relative.

In immunology tests of the patient, only the level of cardiolipin IgM was higher than normal range, [Table 1]. Furthermore, C-reactive protein, rheumatoid factor, rapid plasma reagin, and complete blood count (CBC) tests were normal. In neurologic test, abnormal upper and lower limbs somatosensory evoked potential demonstrated cortical somatosensory pathways conduction delay [Figure 1]. In brain magnetic resonance imaging (MRI), hyperintense lesion of the paraventricular regions and centrum semi-oval were seen [Figure 2].
Table 1: Results of immunology tests for Case-1

Click here to view
Figure 1: Upper and lower limbs somatosensory evoked potential report of Case-1

Click here to view
Figure 2: Magnetic resonance imaging study of the brain without contrast of Case-1: The desired lesions marked with arrow

Click here to view


Case-2 was a 30-year-old daughter that had afflicted to relapsing-remitting MS for 6 years and had not any sign of relapse. She was infected by HPV during relation with a sexual partner. After confirming HPV infection by Pap smear test and curing with podophyllin and in despite consuming immune modulator drugs, interferon beta, she experienced relapses and secondary-progressive MS form with signs such as temporary palsy of body total after 2 months. Cancer, heart and autoimmune diseases were observed in her first-rate family, but there was not history of MS among them. Her personal history was significant for mumps and chicken pox in a child, and anemia later in life.

CBC and immunology tests were normal, but her active disease was shown by evolving neurologic deficits or MRI evidence of new gadolinium-enhanced lesions. So that in cervical spine MRI with and without contrast, focal hyperintense lesion of the cervical cord at C2–C3 level was seen that showed no sign of enhancement after injection of contrast media [Figure 3].
Figure 3: The cervical spine magnetic resonance imaging with and without contrast of Case-2: The desired lesions marked with arrow

Click here to view


Although our study suggested onset or exacerbation of MS disease following genital wart, in according to our laboratory tests, some studies did not provide diagnostic or experimental evidence including the time frame between administration of HPV vaccine and development of MS symptoms.[4] Hence, more studies are needed for surveying association MS with HPV in different population in the future.

Financial support and sponsorship

Nil.

Conflicts of interest

The authors have no conflicts of interest.

 
  References Top

1.
Jaffary F, Musini V, Nilforoushzadeh MA, Bassett K. Systematic review of imiquimod for the treatment of external genital wart. Int J Pharmacol 2007;3:1-10.  Back to cited text no. 1
    
2.
Neshat Doust HT, Nilforoush Zadeh MA, Dehghani F, Molavi H. Effectiveness of cognitive-behavioral stress management therapy on patients' quality of life with alopecia areata in Skin Disease and Leishmaniasis Research Centre of Isfahan. Arak Med Univ J 2009;12:125-33.  Back to cited text no. 2
    
3.
Buljevac D, Flach HZ, Hop WC, Hijdra D, Laman JD, Savelkoul HF, et al. Prospective study on the relationship between infections and multiple sclerosis exacerbations. Brain 2002;125(Pt 5):952-60.  Back to cited text no. 3
    
4.
Sutton I, Lahoria R, Tan I, Clouston P, Barnett M. CNS demyelination and quadrivalent HPV vaccination. Mult Scler 2009;15:116-9.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1]


This article has been cited by
1 Involvement of Kallikrein-Related Peptidases in Nervous System Disorders
Cinthia Mella,Carlos D. Figueroa,Carola Otth,Pamela Ehrenfeld
Frontiers in Cellular Neuroscience. 2020; 14
[Pubmed] | [DOI]



 

Top
Previous article  Next article
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed1835    
    Printed11    
    Emailed0    
    PDF Downloaded117    
    Comments [Add]    
    Cited by others 1    

Recommend this journal