| Title | Parvovirus B19 Infection in Children With Arterial Ischemic Stroke. | ||
| Author | Fullerton, Heather J; Luna, Jorge M; Wintermark, Max; Hills, Nancy K; Tokarz, Rafal; Li, Ying; Glaser, Carol; DeVeber, Gabrielle A; Lipkin, W Ian; Elkind, Mitchell S V | ||
| Journal | Stroke | Publication Year/Month | 2017-Oct |
| PMID | 28864597 | PMCID | PMC5614850 |
| Affiliation + expend | 1.From the Department of Neurology (H.J.F.), Department of Pediatrics (H.J.F.), and Department of Biostatistics and Epidemiology (N.K.H.), University of California, San Francisco; Department of Epidemiology (J.M.L., R.T., W.I.L., M.S.V.E.) and Department of Neurology (M.S.V.E.), Columbia University College of Physicians and Surgeons, New York, NY; Department of Radiology, Stanford University, Palo Alto, CA (M.W., Y.L.); Department of Pediatrics (Infectious Disease), Kaiser Permanente, Oakland, CA (C.G.); and Department of Neurology, Hospital for Sick Children, Toronto, Canada (G.A.D.). | ||
BACKGROUND AND PURPOSE: Case-control studies suggest that acute infection transiently increases the risk of childhood arterial ischemic stroke. We hypothesized that an unbiased pathogen discovery approach utilizing MassTag-polymerase chain reaction would identify pathogens in the blood of childhood arterial ischemic stroke cases. METHODS: The multicenter international VIPS study (Vascular Effects of Infection in Pediatric Stroke) enrolled arterial ischemic stroke cases, and stroke-free controls, aged 29 days through 18 years. Parental interview included questions on recent infections. In this pilot study, we used MassTag-polymerase chain reaction to test the plasma of the first 161 cases and 34 controls enrolled for a panel of 28 common bacterial and viral pathogens. RESULTS: Pathogen DNA was detected in no controls and 14 cases (8.7%): parvovirus B19 (n=10), herpesvirus 6 (n=2), adenovirus (n=1), and rhinovirus 6C (n=1). Parvovirus B19 infection was confirmed by serologies in all 10; infection was subclinical in 8. Four cases with parvovirus B19 had underlying congenital heart disease, whereas another 5 had a distinct arteriopathy involving a long-segment stenosis of the distal internal carotid and proximal middle cerebral arteries. CONCLUSIONS: Using MassTag-polymerase chain reaction, we detected parvovirus B19-a virus known to infect erythrocytes and endothelial cells-in some cases of childhood arterial ischemic stroke. This approach can generate new, testable hypotheses about childhood stroke pathogenesis.