on August 3, 2006
Published online before print August 3, 2006, doi: 10.1161/01.STR.0000236500.15976.f3
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Submitted on May 19, 2006
From the Dipartimento di Scienze Mediche e Chirurgiche, Stroke Unit, Neurologia Vascolare (A.P.) and the Dipartimento di Radiologia, I Radiologia (F.F.), Spedali Civili di Brescia, Brescia, Italia; the Dipartimento di Scienze Mediche e Chirurgiche, Clinica Neurologica (E.D., A.G., A.P.) and the Dipartimento di Scienze Mediche e Chirurgiche, Medicina Interna (G.M., A.G.), Università degli Studi di Brescia, Brescia, Italia; and the Dipartimento di Medicina di Laboratorio (G.R.), III Laboratorio di Analisi Chimico-Cliniche, Spedali Civili di Brescia, Italia. * To whom correspondence should be addressed. E-mail: ale_pezzini{at}hotmail.com.
Background and Purpose--The possibility that a disorder of immunity might have a role in the mechanism of local inflammatory alterations leading to spontaneous cervical artery dissection (sCAD) has been recently advocated. Methods--We explored this hypothesis in a case-control study, including patients with sCAD (n=29) and patients with non-CAD ischemic stroke (non-CAD; n=29). Serum levels of antithyroperoxidase, antithyroglobulin, and antithyroid-stimulating hormone receptor antibodies, antinuclear antibodies, antineutrophil cytoplasmic antibodies, antidouble-stranded deoxyribonucleic acid antibodies, antiextractable nuclear antigen antibodies, rheumatoid factor, C3 and C4 complement fraction, and cryoglobulins were measured in all subjects. Results--Antithyroid autoimmunity was found in 31.0% (9 of 29) of patients with sCAD and 6.9% (2 of 29) of patients with non-CAD ischemic stroke (P=0.041). Conclusions--Autoimmunity may be involved in the process of local inflammation related to sCAD occurrence. The hypothesis that the arterial disease might be one phenotypic expression of a generalized activation of immunity warrants further investigations.
Accepted on June 9, 2006
Thyroid Autoimmunity and Spontaneous Cervical Artery Dissection
Alessandro Pezzini MD*;
Key words: cerebral infarction • dissection • thyroiditis, autoimmune