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J Clin Pathol 2008;61:1209-1213 doi:10.1136/jcp.2008.059840
  • Original article

Deficient leucocyte antisedimentation is related to post-stroke infections and outcome

  1. T Molnar1,
  2. A Peterfalvi2,
  3. L Szereday3,
  4. G Pusch2,
  5. L Szapary2,
  6. S Komoly2,
  7. L Bogar1,
  8. Z Illes2
  1. 1
    Department of Anaesthesiology and Intensive Therapy, University of Pecs, Pecs, Hungary
  2. 2
    Department of Neurology, University of Pecs, Pecs, Hungary
  3. 3
    Department of Medical Microbiology and Immunology, University of Pecs, Pecs, Hungary
  1. Professor Z Illes, Department of Neurology, University of Pecs, Ret u. 2., Pecs 7623, Hungary; zsolt.illes{at}aok.pte.hu
  • Accepted 7 August 2008

Abstract

Background: Patients with stroke are more susceptible to infections, suggesting possible deficiencies of early immune responses, particularly of leucocytes.

Aims: To serially examine leucocyte antisedimentation rate (LAR), a simple test to detect activation of leucocytes, and correlate it with S100β, procalcitonin and outcome in patients with acute ischaemic events.

Methods: Venous blood samples were taken from 61 healthy volunteers and 49 patients with acute ischaemic events (acute ischaemic stroke (AIS), n = 38; transient ischaemic attack (TIA), n = 11) within 6 hours, at 24 and 72 hours after onset of symptoms.

Results: LAR was significantly higher in acute ischaemic events compared to controls within 6 hours after onset of stroke regardless of post-stroke infections. In addition, the increase of LAR was delayed and attenuated in TIA in contrast to AIS. A deficiency in early increase of LAR was associated with post-stroke infections and a poor outcome, measured by the Glasgow Outcome Scale in AIS. There was a positive correlation between LAR and S100β at 72 hours after the onset of ischaemic stroke. Increased levels of S100β at 24 and 72 hours after stroke were associated with poor outcome.

Conclusions: An early activation of leucocytes indicated by an increase of LAR is characteristic of acute ischaemic cerebrovascular events. A delayed and ameliorated leucocyte activation represented by LAR is characteristic of TIA in contrast to stroke. Deficient early activation predisposes to post-stroke infections related to poor outcome. In addition, the extent of tissue injury correlates with the magnitude of innate immune responses.

Footnotes

  • Funding: This study was supported by grants from the Hungarian Research Fund (OTKA T049463 to ZI and F060540 to L Szereday), ETT 50053-2006 and the Bolyai Janos Foundation of the Hungarian Academy of Sciences to ZI.

  • Competing interests: None.

  • Ethics approval: Ethics approval was obtained.

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