Analysis of 14 young cerebrovascular accident cases with positive anti-phospholipid antibody

Abstract

Aims and Objectives: To study of clinical and laboratory findings of 14 young (< 45 years) patients with cerebro vascular accident who were positive for anti-phospholipid antibodies (aPLs). Materials and Methods: The clinical, laboratory, and radiologic findings in 14 young patients with cerebrovascular accident and positive tests for aPLs referred to Shohada Hospital were studied. The analysis for aPLs included estimation of lupus anticoagulant (LA) test, anticardiolipin (aCL) antibodies and anti beta2 glycoprotein 1 antibodies. Other relevant tests included anti-nuclear antibody, human immunodeficiency virus, Venereal Diseases Research Laboratory, platelet count, echocardiography and carotid Doppler. aPL positive strokes were those cases where either the immunoglobulin G (IgG) and/or immunoglobulin M (IgM) were raised or LA or anti beta2 glycoprotein 1 antibodies was positive and other known causes were excluded. Results: Levels of IgG aCL antibody was raised in nine cases and IgM aCL antibody was elevated in 11 cases. Three cases were positive for LA test. Only one patient was positive for anti beta2 glycoprotein 1 test. Seven patients showed small multiple bilateral cerebral infarcts on computerized tomography (CT) scan. Four patients had a history of recurrent strokes. Hemiparesis was more frequent than hemiplegia. One of patient presented with dense hemiplegia. Eleven patients recovered to normal functional capacity and did not have a recurrence on drugs. Conclusion: Cerebrovascular accident in young patients with positive tests for aPL showed certain clinical and radiological features, mild to moderate stroke, pre-treatment recurrences, and multiple smaller infarcts on CT, which could be clustered in a subgroup of stroke in young. These patients showed a better prognosis in terms of long-term outcome.