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Screening psychiatric admissions for anticardiolipin antibody
H A Oomen1, E M Wekking, J de Jong
1Langeveld Center for Psychiatry, Noordwijkerhout, The Netherlands.
Insights
Anticardiolipin antibody (aCL) screening may identify psychiatric patients at risk for future strokes. aCL-positive patients showed increased vascular events over two years, unlike aCL-negative individuals.
Area of Science:
- Neurology
- Immunology
- Psychiatry
Background:
- Anticardiolipin antibodies (aCL) are implicated in vascular events.
- Neuropsychiatric syndromes can be linked to cerebral ischemia.
Purpose of the Study:
- To evaluate anticardiolipin antibody (aCL) as a screening tool for neuropsychiatric syndromes caused by cerebral ischemia.
- To assess the predictive value of aCL for vascular events in psychiatric patients.
Main Methods:
- A cohort of 35 anticardiolipin antibody (aCL)-positive psychiatric patients was matched with aCL-negative controls.
- Clinical records were analyzed for cerebrovascular and systemic vascular symptoms at baseline and after a 2-year follow-up.
- Patient data was assessed without knowledge of aCL status.
Main Results:
- Vascular morbidity, indicative of ischemic central nervous system pathology, was observed in 13 of 35 aCL-positive patients during follow-up.
- No vascular events were documented in the aCL-negative comparison group.
- No correlation was found between Hachinski ischemic scores at admission and aCL positivity.
Conclusions:
- Anticardiolipin antibody (aCL)-IgG/M isotype is a valuable predictor of subsequent ischemic events in psychiatric patients.
- aCL testing may aid in identifying individuals at risk for vascular neuropsychiatric symptoms.
Abstract:
Anticardiolipin antibody (aCL) may provide an instrument for screening in neuropsychiatric syndromes due to cerebral ischemia. Thirty-five psychiatric patients, aCL-positive on admission, were matched against aCL-negative patients. Their clinical records on admission and after 2-years of follow-up were analyzed without knowledge of aCL results. An inventory was made of cerebrovascular and systemic vascular symptoms. In 13 out of 35 aCL-positive cases, vascular morbidity, suggesting ischemic causes of central nervous system pathology, could be demonstrated during follow-up and none in the comparison group. No correlation was found, however, between Hachinski ischemic scores on admission and aCL-positivity. Yet, if only on the basis of increased incidence of subsequent ischemia, the aCL-IgG/M isotype appears to be a valuable predictor of vascular neuropsychiatric symptoms.