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Genetics of MS
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Genetics of MS

My husband's aunt was recently diagnosed with MS. His sister has a B-12 deficiency which we were told is correlated with MS as well. I know there is a genetic component to MS, but I don't know what the chances of our children having MS would be. We currently do not have any children, but should I be worried that our children could develop MS? Should we look into adoption?
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572651_tn?1333939396
Hi Merbear,
There are certainly a large number of children looking for loving families to be adopted by, so please always keep that possibility open.

But don't feel that having your biological children is particularly hazardous.  Although MS is not an inherited disease, people with relatives with MS are more genetically predisposed to having MS, but not by a large enough number to keep you from having children for that reason alone.


Lots of people without MS have B-12 deficiency, so please don't count your sister-in-law as an MS patient (at least not yet!).  

Because this is such a concern, you may want to discuss this all with a genetic counselor and learn more before making a final decision.

Personally, I am glad that I didn't think about the risk of having an aunt with MS before I had my children - they and my grandchildren are a great source of joy and companionship to me.  

My daughter and her husband will probably not have biological children because not only do I have RRMS, his sister has PPMS.  They feel the odds on both sides of the family in such direct relationship is a hard one to gamble on.  However, as advances in treatment and a possible cure looms in the future, they may very well change their minds.

Be well,
Lulu
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572651_tn?1333939396
Before I hit that submit button, I should have also pointed out that you could take this opportunity to learn all you can about MS - most of us will live long, healthy lives with few side effects.  The face of this disease thaat everyone thinks of is a woman in a wheelchair, and nothing could be further from the reality - most people never get to that point.
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870027_tn?1239748527
Thanks for your thoughts LGK54! Reading through the posts on this site has given me a lot of insight into people LIVING with MS...rather than being "stuck" with it, etc. I already know more today than I did yesterday, which I appreciate. Hopefully no matter what we choose to do, I can just do the best job I can raising my children!
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751951_tn?1406636463
I'm not the expert by any means, so please correct me if I misspeak, but if I recall correctly, B12 deficiency is one of the maladies that can mimic MS.  I wasn't aware that having one or the other made the second more likely.
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147426_tn?1317269232
I have a few thoughts here also.

First B12 has no relationship with MS except that people with B12 deficiency can "look" like they have MS.  As Dan said, it mimics MS.

There is little increased risk to a child with a relative outside the nuclear family who has MS.  The reason for this is that there are many, many dozens of genes implicated in causing this disease.  It is not a straight inheritance like blue eyes, sickle cell anemia, or cystic fibrosis.   It appears that several genes must cluster to form the genetic part of the risk.  If they haven't clustered in the nuclear family, then they don't pose much of a risk.

The general risk in the US is about 1 in 800.  But, this also varies by lattitude of where the childhood is spent.  Southern areas is lower than 1 in 1000, but the very far north it may be as common as 1 in 400.  In Canada the risk is higher.  Between 1 in 150 or so to 1 in 350.

If a parent has MS the risk rises to close to 1 in 35 to 1 in 50.  With a sibling it is close to 1 in 25 and closest with an identical sibling.  If a child has MS there is still a backward risk that a parent will develop it later.  MS can develop at any age, even occasionally after age 50 - like in me.

So you see the odds are still against having MS even when it is in the immediate nuclear family.

There are certain genes and tissue types that are "more" commonly associated with MS, but none that could be called even close to an "MS gene."  My guess at the increased risk with  a paternal aunt with MS would be that it might be close to 1 in 200 or 300 or so, but this is ONLY a guess.  I have looked for this data and have not found a reliable source for it.

The lattitude factor (north versus south) may well turn out to be Vitamin D.  Studies are confirming that blood levels of Vitamin D are lower in most all people who develop MS.  In fact, there is good data to suggest that having a mother who is low in Vitamin D during a child's gestation is also a risk factor for the disease.  We "may" find that maintaining strong Vitamin D levels both in a mother-to-be and in the child will have a protective effect.  That has not been proven, but is a theory being tested and analyzed now.  I have advised my own nieces not only to get adequate sunshine, but to have their Vit D levels checked and to supplement if necessary.  

A final piece of the puzzle appears to be a triggering infection.  The most likely candidate, but not the only possibility, is the Epstein-Barr virus, EBV.  Almost all Amercians get infected with EBV.  By early adulthood about 96% of all are already infected, usually with a mild infection in childhood that was never noticed.  However, the risk appears when the person has the most severe form of the EBV infection called Infectious Mononucleosis or "mono."  That seems to be a common risk for MS and some other diseases.

So you can see that genetics is a small part of a person's risk and a paternal aunt does not raise the risk substantially.  While I believe that adoption is a wonderful gift to both the child and a family, you should get all the info you can on the true genetic risk to any children you would have.  You might seek genetic counseling to get the official story.  I am a physician with MS, but not a geneticist.  You can find geneticists to consult with usually in major academic medical centers.  They are often in the Pediatrics department.

I hope this has helped.

Quix, MD
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147426_tn?1317269232
I neglected to mention the racial and ethnic risks.  MS is most common in Caucasion descendants of Northern European heritage.  It is rare in Blacks, Native Americans and Asians.  It is uncommon in Latinos.  These are broad generalities, but need to be mentioned for completeness of the discussion.
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Avatar_f_tn
Wow, you really caught my attention...again!  As I was reading your post I kept saying, yes, yes that's me, I am of Northern European descent, (Dutch), grew up in Michigan, Had a paternal Aunt with MS, Not sure about the vitamin D deficency in Mother while pregnant, but it wouldn't surprise me, she hated to take any kind of medicine, even vitamins.

I had the vit D deficency. I also had a great number of friends who had Mono one winter, tho' I never came down with it, I was definitely exposed.

I also have two cousins who have MS, and one cousin whose two sons have MS. It definitely seems to run in our family!! (all paternal side)

So even with the genetic history, it could have been anything or a combination of some or all. Is there any kind of study out there that my cousins and I can join?  LOL

Cydney27
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807129_tn?1245277127
I just saw this post from 2 months ago when searching for info. on the genetics of MS. Quix's explanation actually answers many of my questions.  

But Cydney, your post caught my eye, because it appears to be turning out that my extended family also has a great genetic predisposition for MS.  My mom & a maternal cousin (my mom's brother's son) have definite MS, I have been in limboland with brain lesions for 6 years, and now another maternal cousin (my mom's twin sister's daughter) has presented with MS symptoms and is beginning the diagnostic journey.  

From reading Quix's post, it sounds like the odds of three cousins all from different but related parents (only 1 of which has MS) having MS is pretty small...but here we are.  And we all grew up in sunny, vitamin D rich, southern California.  

I haven't been able to trace anything that sounds like it could have been MS farther back in our family, but it's possible our grandfather would have had it, but he died in a POW camp in the Korean War.  Eh, I suppose the origin doesn't matter.

But let me know if you find a study for you and your cousins, we'll join you!  Ha!

Laurel
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