Stroke, Vol 22, 1004-1009, Copyright © 1991 by American Heart Association
SF Ameriso, VL Wong, FP Quismorio Jr and M Fisher
We evaluated 50 consecutive patients with acute ischemic stroke to assess
the prevalence of systemic infection preceding the neurological event. We
analyzed the immunohematologic characteristics of patients with and without
signs and/or symptoms of a preceding infectious process. Patients were
examined less than or equal to 7 days after cerebral infarction and
evaluated for fibrinogen, anticardiolipin antibodies, fibrin D-dimer (a
fragment of cross-linked fibrin), plasminogen activator inhibitor-1, and
protein S. Of the 50 patients, 17 had symptoms of infection beginning less
than or equal to 1 month before the stroke (11 had upper respiratory tract
infections, three urinary tract infections, two subacute bacterial
endocarditis, and one pneumonia). Compared with patients without infection,
patients with infection had significant increases in fibrin D-dimer
concentration (5.3 +/- 1.1 versus 4.7 +/- 0.9 log-transformed ng/ml, p less
than 0.05) and cardiolipin immunoreactivity, IgG isotype (1.8 +/- 1.3
versus 1.1 +/- 0.9 log-transformed phospholipid units, p less than 0.04),
and, when studied less than or equal to 2 days after the stroke, increased
fibrinogen levels (459 +/- 126 versus 360 +/- 94 mg/dl, p less than 0.05).
In conclusion, infection-associated cerebral infarction is common and is
associated with substantial immunohematologic abnormalities.
ARTICLES
Immunohematologic characteristics of infection-associated cerebral infarction
Department of Neurology, University of Southern California School of Medicine, Los Angeles 90033.
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