# Span of spleen is associated with disability status in multiple sclerosis: a cross-sectional abdominopelvic ultrasonography study

## TL;DR

This study found that spleen size in people with multiple sclerosis is linked to their disability level, suggesting it could be a potential biomarker.

## Contribution

The study identifies spleen span as a novel potential biomarker for disability status in multiple sclerosis.

## Key findings

- Spleen span was negatively associated with Expanded Disability Status Scale (EDSS) scores in people with multiple sclerosis.
- Spleen span showed fair discrimination ability for the presence of 6-month confirmed disability worsening.
- The association remained significant after adjusting for age, disease-modifying therapies, and MS duration.

## Abstract

Characteristics of livers and spleens of people with multiple sclerosis (pwMS) could constitute good biomarkers of MS-related characteristics such as the disability status. To test the hypothesis “the gross anatomical features of livers and spleens, are not similar between pwMS with different disease characteristics” a cross-sectional study was conducted on pwMS seen at the Isfahan MS clinic, Iran, from February until December 2023. Definitive, otherwise-healthy, pwMS were enrolled after an initial laboratory evaluation. Presence/absence and grading of non-alcoholic fatty liver disease (NAFLD) and the span of spleen were determined by a radiologist using high-resolution abdominopelvic ultrasonography. 193 pwMS (160 women) were enrolled. Of whom, 143 (74.1%) were receiving first-line disease-modifying therapies (DMTs), 24 (12.4%) fingolimod, and 26 (13.5%) rituximab. The span of spleen was negatively associated with EDSS (adjusted β [SE] − 4.08 [1.52], p < 0.01), as well as 6 m-CDW (adjusted β [SE] − 6.94 [3.56], p = 0.05), unlike age, DMTs, and MS duration (all with p > 0.05). Receiver operating characteristic analysis showed, spleen span performs significant but poor in discrimination of EDSS > 1 from EDSS = 1 (area under curve [AUC] 0.62, SE 0.05, p < 0.01), yet, significant and fair in discrimination of presence from absence of 6 m-CDW (AUC 0.72, SE 0.06, p < 0.01). Other findings were unremarkable. Further longitudinal, prospective studies are warranted to confirm whether smaller spleens are predictive of higher disability accrual rate in pwMS. Particularly, findings require further validation in untreated/treatment-naïve pwMS, and ones with higher EDSS scores.