Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 7157  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded35    
    Comments [Add]    

Recommend this journal


Year : 2020  |  Volume : 68  |  Issue : 4  |  Page : 850--855

Association between Appendectomy and Demyelinating Disorders in Subjects 40 Years and Older

1 Sir Charles Gairdner Hospital, Western Australia
2 Department of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
3 Department of Medicine, Monash University Malaysia, Johor Bahru, Malaysia
4 Hospital Pulau Pinang, Penang, Malaysia
5 Department of Medicine, Hospital Sultanah Aminah, Johor Bahru, Malaysia
6 Department of Neurology, KPJ Johor Specialist Hospital, Johor, Malaysia
7 Undergraduate Medical Student, Penang, Malaysia
8 School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
9 Department of Surgery, Monash University Malaysia, Johor Bahru, Malaysia

Correspondence Address:
Dr. Suneet Sood
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 8 Masjid Jalan Abu Bakar, 80100 Johor Bahru, Johor
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.293469

Rights and Permissions

Background: The association between appendectomy and multiple sclerosis (MS) is unknown. In this study, we explored the association between appendectomy and MS and neuromyelitis optica spectrum disorder (NMOSD). Patients and Methods: MS and NMOSD patients older than 40 were identified from neurology records from hospitals in Malaysia. The diagnoses were based on the Revised McDonald (2010) and Wingerchuk (2015) criteria. Controls were sampled from Malaysia's normal population. Individuals were interviewed telephonically or face-to-face. The age inclusion criterion (over 40) differentiated high or low lifetime risk of appendicitis, as appendicitis incidence is rare after 40. Results: 49 MS, 71 NMOSD, and 880 controls met the inclusion criteria. Seventy-two individuals (9 MS, 4 NMOSD, 59 control) had undergone appendectomy. Appendectomy rates were 18.37% in the MS group (95% CI 7.5–29.2%), 5.6% in the NMOSD group (0.3%, 11%), and 6.7% among controls (5.1%, 8.4%), (MS vs NMOSD P = 0.036, MS vs controls P = 0.007). Binary regression analysis showed that MS was an independent risk factor for appendectomy (OR 2.938, 95% CI 1.302, 6.633, P = 0.009). NMOSD showed no association with appendectomy. Conclusion: MS is positively associated with appendectomy, unlike ulcerative colitis, which is negatively associated. We hypothesize that there is a commonality in the microflora in persons who have had these two illnesses.


Print this article     Email this article

Online since 20th March '04
Published by Wolters Kluwer - Medknow