Clinical Research in Stroke

Komatsu T.a· Kida H.a· Ozawa M.a· Mimori M.a· Kokubu T.a· Takahashi J.a· Kurihara S.a· Maku T.a· Motegi H.a· Takahashi M.a· Shiraishi T.a· Nakada R.a· Kitagawa T.a· Sato T.a· Takatsu H.a· Sakai K.a· Umehara T.a· Omoto S.a· Murakami H.a· Mitsumura H.a· Yokoo T.b· Iguchi Y.a

Author affiliations

aDepartment of Neurology, The Jikei University School of Medicine, Tokyo, Japan
bDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

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Article / Publication Details

First-Page Preview

Received: May 04, 2022
Accepted: September 03, 2022
Published online: November 08, 2022

Number of Print Pages: 10
Number of Figures: 4
Number of Tables: 2

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

Abstract

Background: Cerebral microbleeds (CMBs) detected on susceptibility-weighted imaging (SWI) are associated with cerebral small vessel disease. Chronic kidney disease and microalbuminuria have been associated with the presence of CMBs in stroke patients. Urinary immunoglobulin G (IgG) is measured to document glomerular injury; however, the relationship between urinary IgG and CMBs is unknown. Methods: We retrospectively enrolled consecutive patients who had been admitted with transient ischemic attack (TIA) or ischemic stroke and identified those who had undergone SWI and a spot urine test. The location of CMBs was classified on magnetic resonance imaging as strictly lobar, deep/infratentorial (D/I), or mixed areas. We analyzed the association between urinary IgG and the presence and location of CMBs. Results: We included 298 patients (86 female, median age 70 years, median eGFR 65.8 mL/min/1.73 m2). Positive urinary IgG and CMB results were found in 58 (19%) and 160 patients (54%), respectively. Urinary IgG positivity was significantly associated with CMBs compared with non-CMBs (28% vs. 9%, p < 0.001), and with D/I or mixed CMBs compared with non-D/I or mixed CMBs (34% vs. 10%, p < 0.001). Multivariate analysis revealed that urinary IgG and hypertension positivity were strongly associated with D/I or mixed CMBs (OR 3.479, 95% CI: 1.776–6.818, p < 0.001; OR 3.415, 95% CI: 1.863–6.258, p < 0.001). Conclusions: Urinary IgG was associated with the prevalence of D/I or mixed location CMBs in TIA or ischemic stroke patients. Our findings provide new insights into the association between urinary IgG and the distribution of CMBs.

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First-Page Preview

Received: May 04, 2022
Accepted: September 03, 2022
Published online: November 08, 2022

Number of Print Pages: 10
Number of Figures: 4
Number of Tables: 2

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

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