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Urinary Immunoglobulin G Is Associated with Deep and Infratentorial Cerebral Microbleeds in Stroke Patients
Teppei Komatsu1, Hiroyuki Kida1, Masakazu Ozawa1
1Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
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.
Insights
Urinary immunoglobulin G (IgG) is linked to deep or mixed cerebral microbleeds (CMBs) in stroke patients. This finding highlights a potential connection between kidney injury markers and microbleed distribution.
Area of Science:
- Neurology
- Nephrology
- Radiology
Background:
- Cerebral microbleeds (CMBs) are markers of cerebral small vessel disease.
- Chronic kidney disease and microalbuminuria are linked to CMBs in stroke patients.
- The association between urinary immunoglobulin G (IgG) and CMBs is not well understood.
Purpose of the Study:
- To investigate the relationship between urinary IgG and the presence and location of CMBs in patients with transient ischemic attack (TIA) or ischemic stroke.
Main Methods:
- Retrospective analysis of 298 patients who underwent susceptibility-weighted imaging (SWI) and spot urine testing.
- Classification of CMB location: strictly lobar, deep/infratentorial (D/I), or mixed.
- Statistical analysis of the association between urinary IgG and CMB presence/location.
Main Results:
- Urinary IgG positivity was found in 19% of patients, and CMBs in 54%.
- Urinary IgG was significantly associated with the presence of CMBs (28% vs. 9%) and D/I or mixed CMBs (34% vs. 10%).
- Multivariate analysis showed urinary IgG and hypertension were strongly associated with D/I or mixed CMBs (OR 3.479 and 3.415, respectively).
Conclusions:
- Urinary IgG is associated with the prevalence of deep/infratentorial or mixed location CMBs in TIA or ischemic stroke patients.
- These findings suggest a link between urinary IgG, a marker of glomerular injury, and the distribution patterns of CMBs.
