Infection of the Central Nervous System, Sepsis and Amyotrophic Lateral Sclerosis

Severe infections may lead to chronic inflammation in the central nervous system (CNS) which may in turn play a role in the etiopathogenesis of amyotrophic lateral sclerosis (ALS). The relentless progression and invasive supportive treatments of ALS may on the other hand induce severe infections among ALS patients.The present study included 4,004 ALS patients identified from the Swedish Patient Register during 1991-2007 and 20,020 age and sex matched general population controls. Conditional logistic regression was used to estimate the odds ratios (ORs) of ALS given a previous hospitalization for CNS infection or sepsis. Cox models were used to estimate the hazard ratios (HRs) of hospitalization for CNS infection or sepsis after ALS diagnosis. Overall, previous CNS infection (OR: 1.3, 95% confidence interval [CI]: 0.8, 2.4) or sepsis (OR: 1.2, 95% CI: 0.9, 1.6) was not associated with ALS risk. However, compared to ALS free individuals, ALS cases were more likely to be hospitalized for sepsis after diagnosis (HR: 2.6, 95% CI: 1.9, 3.5). We did not observe a higher risk of CNS infection after ALS diagnosis.Our results suggest that acute and severe infections unlikely contribute to the development of ALS; however, ALS patients are at a higher risk of sepsis after diagnosis, compared to ALS free individuals

Basic characteristics of amyotrophic lateral sclerosis cases, a nested case-control study in Sweden, 1991–2007.

<p>*Cases first recorded in the Outpatient Register during 2002–2007.</p

Hazard ratios of hospitalization for sepsis after amyotrophic lateral sclerosis, a follow-up study in Sweden, 1991–2007.

<p>*Hazard ratios and 95% confidence intervals, adjusting for year of birth and sex.</p>†<p>Cases first recorded in the Outpatient Register during 2002–2007.</p

Previous hospitalizations for infection of the central nervous system (CNS) or sepsis and the risk of amyotrophic lateral sclerosis, a nested case-control study in Sweden, 1991–2007.

<p>*Odds ratios and 95% confidence intervals, adjusting for year of birth and sex.</p>†<p>Cases first recorded in the Outpatient Register during 2002–2007.</p