Article type: Research Article
Authors: Bandaru, V.C.S. Srinivasarao | Boddu, Demudu Babu | Singh, Vineeta | Akhila, Boddu | Laxmi, Vemu | Neeraja, Mamedi | Kumar, Bana Ashok | Reddy, Gunnamreddy Ramana | Jyotsna, Yarlagadda | Kaul, Subhash
Affiliations: Department of Neurology, Nizam's Institute of Medical
Sciences, Panjagutta, Hyderabad, India | Department of Neurology, University of California, San
Francisco, CA, USA | Department of Microbiology, Nizam's Institute of
Medical Sciences, Panjagutta, Hyderabad, India | Department of Neurology, Kurnool Medical College,
Kurnool, India | Department of Neurology, NRI Medical College, Guntur,
India | Department of Radiology, Nizam's Institute of Medical
Sciences, Panjagutta, Hyderabad, India
Note: [] Correspondence: Dr. Subhash Kaul, M.D., %Professor and Head
Department of Neurology, Nizam's Institute of Medical Sciences Panjagutta,
Hyderabad, 500082, India. Tel.: +91 040 23320332, ext 143; Fax: +91 040
30602165; E-mail: subashkaul@hotmail.com
Abstract: Several studies have shown that Chlamydia pneumoniae
accelerates atherothrombosis by cytokine-mediated process with increased risk
of cerebral ischemia in adults. Such a relationship has not been established in
children. We sought to study the role of C. pneumoniae infection in
children under the age of 18~years presenting with first ever-ischemic stroke.
This study was carried out at a tertiary care hospital, between January 2006
and December 2008. Using a prospective registry, we enrolled all consecutive
childhood stroke patients presenting within 72 h of stroke onset. All patients
underwent neuroimaging tests as a part of their stroke work up. In addition to
routine blood investigations, hypercoagulable panel and fasting lipid profile
were estimated for all participants. We measured C. pneumoniae IgG and
IgA antibodies, by microimmunofluorescence technique, for all participants. A
total of 42 children under the age of 18 years who presented with acute
ischemic stroke were studied. The mean age of presentation was 15.2 years and
males outnumbered females by 5:2. Stroke risk factors were identified in 33 of
42 (80%) cases. C. pneumoniae seropositivity (IgG) was found in 14 of
the 42 stroke patients. After adjustment in C. pneumoniae seropositive
strokes, abnormal intima media thickness (odds ratio [OR]: 7.0; 95%
confidence interval [CI]: 1.2–37.9), elevated total cholesterol (OR: 9.3;
95% CI: 1.6–53.2) and low-density lipoprotein cholesterol (OR: 27.0; 95%
CI: 2.5–291.1) were significantly associated with ischemic stroke in children.
C. pneumoniae infection is associated with atherogenic lipid profile in
children presenting with acute ischemic stroke.
Keywords: Pediatric stroke, C. pneumoniae, intima media thickness, low-density lipoprotein cholesterol, total cholesterol
DOI: 10.3233/JPN-2010-0413
Journal: Journal of Pediatric Neurology, vol. 8, no. 4, pp. 367-373, 2010
Received 16 November 2009
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Accepted 1 December 2009
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Published: 2010
