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Evidence of Intrathecal Immunoglobulin Synthesis in Stroke: A Cohort Study.
MedLine Citation:
PMID:  22371852     Owner:  NLM     Status:  Publisher    
BACKGROUND: Immune mechanisms are included in stroke pathophysiologic factors, but the frequency and role of intrathecal antibodies is unclear and diagnostic tests are not routinely performed on cerebrospinal fluid (CSF). OBJECTIVE: To determine the frequency of intrathecal immunoglobulin synthesis in a well-characterized cohort of patients who experienced "noninflammatory" acute stroke. DESIGN: Retrospective cohort study. SETTING: University hospital neurology department. Patients  Patients (n = 318) with stroke who were undergoing lumbar puncture during diagnostic workup and 79 control patients. RESULTS: Cerebrospinal fluid-specific immunoglobulin (IgG, IgM, and IgA) synthesis was significantly (P < .001) more frequent after stroke (24.8%) compared with the incidence in age- and sex-matched controls (2.5%). Furthermore, 31.3% of stroke patients demonstrated blood-brain barrier dysfunction and 18.1% displayed pleocytosis. CONCLUSION: The strong association between CSF-specific immunoglobulin synthesis and stroke suggests a role in the development of cerebral ischemia and might constitute an immunologically defined stroke subgroup.
Harald Prüss; Deetje Iggena; Tina Baldinger; Vincent Prinz; Andreas Meisel; Matthias Endres; Ulrich Dirnagl; Jan M Schwab
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-27
Journal Detail:
Title:  Archives of neurology     Volume:  -     ISSN:  1538-3687     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Center for Stroke Research, and Center of Excellence NeuroCure, Charité Universitätsmedizin Berlin, Berlin, Germany (Drs Prüss, Iggena, Baldinger, Prinz, Meisel, Endres, Dirnagl, and Schwab); and Division of Immunology, Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts (Dr Prüss).
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