Background: Younger patients, aged below 45 years, usually lack the conventional risk factors of stroke whereas infections, especially in developing countries, may play a role. There have been many reports in the last decade about the association of Chlamydia pneumoniae (C. pneumoniae) and atherosclerosis involving cerebral vessels.
Objective: To investigate the seroprevalence of C. pneumoniae IgG and IgA antibodies in patients aged below 45 years with acute ischemic stroke.
Methods: This study was done at a tertiary care hospital in South India between January 2004 and December 2006 where we recruited consecutive patients aged less than 45 years with acute ischemic stroke. Age and sex matched controls were recruited from the outpatient department with non stroke diagnosis. All stroke patients underwent CT (Computerized Tomography), MRI (Magnetic Resonance Image), MRA (Magnetic Resonance Angiography), Transthoracic Echocardiography and Carotid Doppler for stroke sub group diagnosis. We measured C. pneumoniae antibodies IgG and IgA by microimmunofluorescence technique in all patients and controls.
Results: A total of 120 patients and 120 controls were studied over a period of two years. We found C. pneumoniae antibodies in 29.1% (35/120) stroke patients and in 12.5% (15/120) control subjects (p=0.002). C. pneumoniae IgG antibodies were found in 27.5 % (33/120) of stroke patients and 12.5% (15/120) of controls (p=0.006). IgA antibodies were observed in 5% (6/120) of strokes and none in control group (p=0.03). After adjustment of all risk factors C. pneumoniae IgG seropositivity showed odds ratio of 2.6; 95% Confidence Interval 1.2-5.6.
Conclusions: C. pneumoniae IgG antibodies were found to be associated with ischemic stroke in young.