Brief Answer: More information required to consider possible MS Detailed Answer: Hi Ms. XXXXXXX Thanks for your query. Firstly, you have neither enumerated the symptoms/facts which make you feel that you may have MS nor, the medicines, taken ever since the diagnosis of SLE was made. You will appreciate that in SLE- an autoimmune disease- antibodies are formed against any part and organs of the body. Antibodies against kidney tissues, causes kidney involvement which progresses to kidney failure. Apparently, the flare up of SLE is the cause of kidneys' affection. Since steroids are used in all cases of SLE, I presume that you too were on high doses of steroids in the past, which could be the cause of Adrenal inefficiency (Addison's Disease). Autoantibodies against the intestinal lining, destroy the intestinal lining with consequent impaired digestion/absorption, particularly of vitamins(B12 and Folic acid) and minerals, particularly calcium. Persistent Pernicious anemia is due to chronic Vitamin B12 and Folic acid. Since their absorption is impaired, these vitamins in INJECTABLE form, will be effective in curing pernicious anemia. Beta Thalassemia is responsible for chronic anemia. Low blood counts (thrombocytopenia and leukopenia) are manifestations of SLE. Pernicious anemia, gastric polyps can be hereditary, IRRESPECTIVE OF YOUR ANCESTRY. Hence, you should undergo endoscopy/colonoscopy to rule out/detect intestinal/gastric polyps. In a nutshell, all abnormalities and bone marrow findings conform to the manifestations of SLE. Perhaps, if you provide me with your entire symptoms in detail, I can opine on the possibility of MS. Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal

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Brief Answer: Genetic aspects of SLE and MS are given below Detailed Answer: Hi Ms. XXXXXXX Nice hearing back from you. Let us not confuse between Genetic and Hereditary diseases. The latter are due to chromosomal disorders, while Genetic diseases are due to abnormality of a specific gene(s). Both- SLE and MS- are autoimmune diseases, which are linked to differences in the human leukocyte antigen (HLA) system—a group of genes on chromosome 6. Susceptibility (that is, increased genetic tendency) to developing either SLE/MS or other autoimmune diseases, depends on the genes (in HLA system) in which changes occur. All your blood disorders are manifestations of SLE. Further, both conditions have several similarities in their manifestation, signs and symptoms. However, there is destruction of the protective sheath (called myelin) of the brain and nerves in MS. Absence of findings of destroyed myelin sheath in MRI of brain and/or Spinal cord EXCLUDES MS (as in your case). Differences in genetic abnormalities in the HLA system confirms the diagnosis of SLE/MS. Hence, tests for HLA genes' abnormalities would confirm the diagnosis. Genetic Karyotyping would identify all abnormal genes. On the other hand, in your case, Pernicious Anemia is present in three generations. In Pernicious anemia (PA), there is a severe lack of Intrinsic Factor (IF), which is produced in the stomach lining. It mediates in the process of absorption of Vitamin B12 (Cobalamin). The gene of IF is present on Chromosome 11. Abnormality or mutation of this gene leads to severe deficiency of IF and, in turn, causes Vitamin B12 deficiency. PA is a common disease in north Europeans but occurs in all countries and ethnic groups. The overall incidence is about 120 per 100,000 population in the United Kingdom (UK). The peak age of onset is 60 years, with only 10% of patients being <40 years of age. However, in some ethnic groups, notably black individuals and Latin Americans, the age at onset of PA is generally lower. Also, PA is commonly associated with other autoimmune diseases, including Addison's disease and SLE (but NOT MS). Since you have a mixed (African + European lineage- as per DNA test, the onset of the disease occurred at an early age. MS is more common in northern North XXXXXXX northern Europe, southern Australia, and south New Zealand), the prevalence of MS is 0.1–0.2%. By contrast, in Asia, equatorial Africa, and the Middle East), the prevalence is often ten- to twentyfold less. Hence, given your lineage, you are at a lesser risk of developing MS, as compared to SLE. Hope I have provided you the information you desired. Take care

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