1. Increased anticardiolipin antibody IgG titers do not predict recurrent stroke or TIA in children.
- Author
-
Lanthier S, Kirkham FJ, Mitchell LG, Laxer RM, Atenafu E, Male C, Prengler M, Domi T, Chan AK, Liesner R, and deVeber G
- Subjects
- Antiphospholipid Syndrome blood, Antiphospholipid Syndrome immunology, Brain Ischemia blood, Brain Ischemia epidemiology, Brain Ischemia immunology, Child, Child, Preschool, Cohort Studies, Comorbidity, Confounding Factors, Epidemiologic, Disease-Free Survival, Female, Fibrinolytic Agents therapeutic use, Follow-Up Studies, Humans, Ischemic Attack, Transient blood, Ischemic Attack, Transient epidemiology, Ischemic Attack, Transient immunology, Life Tables, London epidemiology, Male, Ontario epidemiology, Platelet Aggregation Inhibitors therapeutic use, Prospective Studies, Recurrence, Risk, Survival Analysis, Thrombophilia blood, Thrombophilia drug therapy, Thrombophilia immunology, Antibodies, Anticardiolipin blood, Antiphospholipid Syndrome complications, Brain Ischemia etiology, Immunoglobulin G blood, Ischemic Attack, Transient etiology, Thrombophilia etiology
- Abstract
Background: Increased anticardiolipin antibody (ACLA) immunoglobulin (Ig) G titers are commonly found in children with arterial ischemic stroke (AIS) or TIA (AIS/TIA). The associated risk of recurrent thromboembolism is unknown., Objective: To determine the risk of recurrent thromboembolism associated with persistently increased ACLA titers of the IgG isotype in children with AIS/TIA., Methods: The authors studied a cohort of children surviving first AIS/TIA tested by standardized ELISA for beta2-glycoprotein I-dependent ACLA of the IgG isotype. Children with ACLA titers >15 IgG phospholipid (GPL) units (per manufacturer's cutoff point) on more than two occasions > or =6 weeks apart were classified as ACLA-positive (ACLA+) and compared with ACLA-negative (ACLA-) children with respect to recurrent thromboembolic events (AIS/TIA, sinovenous thrombosis, and extracerebral thromboembolism)., Results: The authors recruited 34 ACLA+ children and 151 ACLA- children. Most ACLA+ children (30/34; 88%) had ACLA titers < or =40 GPL units. During the follow-up period (median duration, 2.8 years for ACLA+ children and 3.0 years for ACLA- children), AIS/TIA recurred in 26% of ACLA+ children and in 38% of ACLA- children; none developed sinovenous thrombosis or extracerebral thromboembolism. Based on survival analysis, this difference was nonsignificant (p = 0.54). Using binary partition evaluation, no titer criteria for ACLA positivity (range, 0 to 60 GPL units) predicted recurrent AIS/TIA., Conclusion: In children surviving arterial ischemic stroke/TIA, increased anticardiolipin antibody immunoglobulin G titers do not predict recurrent thromboembolism.
- Published
- 2004
- Full Text
- View/download PDF