Neurology and Neuromuscular Disorders

Biography

Biography: Husham Bayazed

Abstract

Anti-phospholipid syndrome (APS) is an autoimmune disease. Cerebral ischemia associated with APS occurs at a younger age than typical atherothrombotic cerebrovascular disease, is often recurrent and is associated with high positive IgG anti-phospholipid (GPL) unit levels. This study sought to determine the frequency rates of anti-cardiolipin (aCL) dependent on the presence of β2-GPI, anti-β2-glycoprotein I (aβ2-GPI) and anti-phosphatidyl serine (aPS) IgG autoantibodies among stroke patients and thus demonstrate the importance of testing for aβ2-GPI autoantibodies. Stroke patients and control subjects recruited from Mosul, Erbil and Dohuk provinces in Northern Iraq were evaluated. All cases were under 50 years-of-age and had no recognizable risk factors. ELISA was used to evaluate the presence of IgG isotype of aCL, aβ2-GPI, and aPS autoantibodies in their blood, the results indicated that the frequency of aβ2-GPI was 14/50 (28%), aCL was 11/50 (22%) and aPS was 9/50 (18%) among stroke patients. In contrast, aCL was detected in 2/30 (6.7%) of control subjects; each of the other anti-phospholipid antibodies (APLA) was never observed. Of all the aβ2-GPI+ cases, the incidence of stroke patients having the combined profile of aβ2-GPI+aCL was 11/14 (78.6%) and of aβ2-GPI+aPS was 9/14 (64.3%) only 2/14 (14.3%) of these aβ2-GPI+ patients expressed aCL in the absence of aPS. The frequency of patients expressing all three markers was only 9/14 (64.3 %). In none of the APS/stroke patients were aCL or aPS expressed in the absence of the aβ2-GPI. Conversely, IgG aβ2-GPI as a sole marker was seen in 3/14 (21.4%) of these patients (i.e. in absence of either other marker). It can be concluded from these studies that among the three major forms of APLA examined, the presence of IgG aβ2-GPI autoantibodies appeared to correlate best with stroke in patients who were concurrently suffering from APS.