Antiphospholipid antibodies in young Indian patients with stroke

Background : Stroke may be caused by antiphospholipid antibodies (APL), especially in young persons without other risk factors. Aim : The aim of this study was to determine the prevalence of two clinically significant APL-anticardiolipin antibody (ACL) and lupus anticoagulants (LA) in young patients presenting with sudden neurological deficit. Settings and Design : A case-control study performed in a large tertiary care government hospital. Materials and Methods : Ten milliliters of blood was collected from 51 consecutive young patients (age less than 45 years) diagnosed as ischemic stroke and 50 healthy age- and sex-matched controls. Statistical Analysis : Statistical analysis was done using Epi Info^TM 6 software. Results : Overall, the risk factor profile was: Smoking (23.5%), positive family history (13.7%), hyperlipidemia (8%), and diabetes mellitus (3.6%). APL (LA and ACL) were present in 29.4% of the samples and in 4% of controls. The ′P′ value for ACL and LA was 0.03 and 0.02 respectively, but the maximum level of ACL was 25 GPL units only. One-fourth of the patients were smokers and one-sixth had a family history of thrombosis ( P = 0.048 and 0.036, respectively). Conclusions : APL, positive family history and smoking were significantly associated with stroke in the young. We advocate screening for APL in all young patients with stroke.