Hypogammaglobulinemia: A contributing factor to multiple sclerosis fatigue?

Fatigue is one of the most disabling and difficult to treat symptoms of autoimmune diseases and frequently presents in people with multiple sclerosis (PwMS). Hypogammaglobulinemia for immunoglobulin G (IgG) affects approximately 8–25% of PwMS. We performed a retrospective analysis to investigate the association of MS-fatigue and IgG hypogammaglobulinemia. PwMS, treated at Eginition University Hospital Athens or at the University Hospital Bern, were included (n = 134 patients (Bern n = 99; Athens n = 35)). Mann Whitney U-test (MWT), ANOVA test, Chi2 test and multivariable linear regression models were run. 97/134 (72.4%) PwMS reported fatigue. In the multivariable linear regression analysis, IgG serum concentration (–1.6, 95%CI –2.7 - –0.5, p = 0.006), daytime sleepiness (0.8, 95%CI 0.2–1.4, p = 0.009), and a depressive mood (1.1, 95%CI 0.8–1.4, p