Small vessel occlusion and syphilis in patients with first-ever ischemic stroke

ABSTRACT Background: Syphilis is an endemic disease, particularly in low- and middle-income countries, with vascular involvement in large vessels (aortitis), but no clear relationship with stroke patients, except for those who presented with meningovascular neurosyphilis. Objective: To investigate...

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Main Authors: Matheus Gomes Ferreira, Valeria Cristina Scavasine, Giovanni Luís Breda, Bernardo Montesanti Machado de Almeida, Viviane de Hiroki Flumignan Zétola, Marcos Christiano Lange
Format: Article
Language:English
Published: Thieme Revinter Publicações 2021-03-01
Series:Arquivos de Neuro-Psiquiatria
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000200103&tlng=en
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author Matheus Gomes Ferreira
Valeria Cristina Scavasine
Giovanni Luís Breda
Bernardo Montesanti Machado de Almeida
Viviane de Hiroki Flumignan Zétola
Marcos Christiano Lange
author_facet Matheus Gomes Ferreira
Valeria Cristina Scavasine
Giovanni Luís Breda
Bernardo Montesanti Machado de Almeida
Viviane de Hiroki Flumignan Zétola
Marcos Christiano Lange
author_sort Matheus Gomes Ferreira
collection DOAJ
description ABSTRACT Background: Syphilis is an endemic disease, particularly in low- and middle-income countries, with vascular involvement in large vessels (aortitis), but no clear relationship with stroke patients, except for those who presented with meningovascular neurosyphilis. Objective: To investigate the relationship between a positive history of syphilis determined by serological testing and ischemic stroke etiology, particularly small vessel disease (SVD). Methods: In total, 269 first-ever ischemic stroke patients admitted to the stroke unit were tested for syphilis. Patients with neurosyphilis were excluded. All patients were classified according to the ASCOD phenotyping as SVD — when SVD was the potential causal mechanism (S1) — or non-SVD — when SVD was uncertain (S2), unlike (S3), or not detected (S0). Results: Syphilis was positive in 32 (12%) patients. When comparing patients with positive and negative serology, the only significant difference was SVD as the causal mechanism (S1) in patients with positive results: 9 (28%) vs. 22 (9%), p<0.01. Conclusion: The current study showed that the frequency of positive syphilis serological test was higher in patients with first-ever ischemic stroke and SVD as the potential causal mechanism. This finding could be related to the endothelial dysfunction occurring in syphilis.
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spelling doaj-art-e6d7ae68b4b049ad823c72495ce3db822025-08-20T03:24:58ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272021-03-0179210310610.1590/0004-282x-anp-2020-0178Small vessel occlusion and syphilis in patients with first-ever ischemic strokeMatheus Gomes Ferreirahttps://orcid.org/0000-0002-5288-4739Valeria Cristina Scavasinehttps://orcid.org/0000-0002-2972-0971Giovanni Luís Bredahttps://orcid.org/0000-0001-7092-8830Bernardo Montesanti Machado de Almeidahttps://orcid.org/0000-0001-5293-3652Viviane de Hiroki Flumignan Zétolahttps://orcid.org/0000-0001-8464-9488Marcos Christiano Langehttps://orcid.org/0000-0002-0405-7157ABSTRACT Background: Syphilis is an endemic disease, particularly in low- and middle-income countries, with vascular involvement in large vessels (aortitis), but no clear relationship with stroke patients, except for those who presented with meningovascular neurosyphilis. Objective: To investigate the relationship between a positive history of syphilis determined by serological testing and ischemic stroke etiology, particularly small vessel disease (SVD). Methods: In total, 269 first-ever ischemic stroke patients admitted to the stroke unit were tested for syphilis. Patients with neurosyphilis were excluded. All patients were classified according to the ASCOD phenotyping as SVD — when SVD was the potential causal mechanism (S1) — or non-SVD — when SVD was uncertain (S2), unlike (S3), or not detected (S0). Results: Syphilis was positive in 32 (12%) patients. When comparing patients with positive and negative serology, the only significant difference was SVD as the causal mechanism (S1) in patients with positive results: 9 (28%) vs. 22 (9%), p<0.01. Conclusion: The current study showed that the frequency of positive syphilis serological test was higher in patients with first-ever ischemic stroke and SVD as the potential causal mechanism. This finding could be related to the endothelial dysfunction occurring in syphilis.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000200103&tlng=enSyphilisStrokeCerebral Small Vessel Diseases
spellingShingle Matheus Gomes Ferreira
Valeria Cristina Scavasine
Giovanni Luís Breda
Bernardo Montesanti Machado de Almeida
Viviane de Hiroki Flumignan Zétola
Marcos Christiano Lange
Small vessel occlusion and syphilis in patients with first-ever ischemic stroke
Arquivos de Neuro-Psiquiatria
Syphilis
Stroke
Cerebral Small Vessel Diseases
title Small vessel occlusion and syphilis in patients with first-ever ischemic stroke
title_full Small vessel occlusion and syphilis in patients with first-ever ischemic stroke
title_fullStr Small vessel occlusion and syphilis in patients with first-ever ischemic stroke
title_full_unstemmed Small vessel occlusion and syphilis in patients with first-ever ischemic stroke
title_short Small vessel occlusion and syphilis in patients with first-ever ischemic stroke
title_sort small vessel occlusion and syphilis in patients with first ever ischemic stroke
topic Syphilis
Stroke
Cerebral Small Vessel Diseases
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000200103&tlng=en
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