Is Chlamydia pneumoniae infection associated with stroke in children with sickle cell disease?

Meenakshi Goyal, Scott T. Miller, Margaret R. Hammerschlag, Maureen Gelling, Charlotte A Gaydos, Justin Hardick, Billie Jo Wood, Tamara Reznik, S. P. Rao

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Stroke is often a devastating complication of sickle cell disease (SCD). Most children with SCD-related stroke have stenotic and occlusive disease of cerebral blood vessels due to intimal hyperplasia. This hyperplasia is hypothesized to result from an inflammatory response similar to that in atherosclerosis and has been attributed to infection by Chlamydia pneumoniae. OBJECTIVE: To determine whether C pneumoniae infection is associated with stroke and cerebrovascular disease, including transient ischemic attacks and abnormal transcranial Doppler examinations, in children with SCD. METHODS: Children with SCD on chronic transfusion due to a history of stroke, transient ischemic attack, or abnormal transcranial Doppler; children with SCD without stroke; healthy controls; and children being transfused for other reasons were enrolled. Peripheral blood and nasopharyngeal (NP) swab specimens were collected from all patients. In patients on transfusion, pretransfusion specimens and samples from the unit of packed red blood cells being transfused were obtained. Peripheral blood monocytic cells (PBMCs) and NP swab specimens were cultured for C pneumoniae in HEp-2 cells. C pneumoniae polymerase chain reaction was performed on PBMCs with a nested touch-down method with primers from the omp-1gene (in duplicate) and a second real-time polymerase chain reaction by using 16S ribosomal RNA primers. RESULTS: C pneumoniae DNA was detected in the PBMCs of 1 of 14 (7.1%) children with SCD on chronic transfusion, 1 of 10 (10%) sickle cell controls, 1 of 10 (10%) healthy controls, and none of the 5 children receiving chronic transfusion for other reasons. It was not detected in specimens from transfusion units. One child with SCD and stroke, 1 sickle cell control, and 1 transfusion control had positive NP cultures for C pneumoniae. C pneumoniae DNA was not detected in their PBMCs, and all 3 children were asymptomatic. C pneumoniae was not detected by culture of PBMCs from any of the patients after 7 passages. CONCLUSION: Stroke in children with SCD does not seem to be associated with C pneumoniae infection in our population.

Original languageEnglish (US)
JournalPediatrics
Volume113
Issue number4
StatePublished - Apr 2004
Externally publishedYes

Fingerprint

Chlamydophila pneumoniae
Chlamydia Infections
Sickle Cell Anemia
Stroke
Pneumonia
Blood Cells
Transient Ischemic Attack
Hyperplasia
Infection
Tunica Intima
16S Ribosomal RNA
Cerebrovascular Disorders
DNA
Touch
Blood Vessels
Real-Time Polymerase Chain Reaction
Atherosclerosis
Erythrocytes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Goyal, M., Miller, S. T., Hammerschlag, M. R., Gelling, M., Gaydos, C. A., Hardick, J., ... Rao, S. P. (2004). Is Chlamydia pneumoniae infection associated with stroke in children with sickle cell disease? Pediatrics, 113(4).

Is Chlamydia pneumoniae infection associated with stroke in children with sickle cell disease? / Goyal, Meenakshi; Miller, Scott T.; Hammerschlag, Margaret R.; Gelling, Maureen; Gaydos, Charlotte A; Hardick, Justin; Wood, Billie Jo; Reznik, Tamara; Rao, S. P.

In: Pediatrics, Vol. 113, No. 4, 04.2004.

Research output: Contribution to journalArticle

Goyal, M, Miller, ST, Hammerschlag, MR, Gelling, M, Gaydos, CA, Hardick, J, Wood, BJ, Reznik, T & Rao, SP 2004, 'Is Chlamydia pneumoniae infection associated with stroke in children with sickle cell disease?', Pediatrics, vol. 113, no. 4.
Goyal M, Miller ST, Hammerschlag MR, Gelling M, Gaydos CA, Hardick J et al. Is Chlamydia pneumoniae infection associated with stroke in children with sickle cell disease? Pediatrics. 2004 Apr;113(4).
Goyal, Meenakshi ; Miller, Scott T. ; Hammerschlag, Margaret R. ; Gelling, Maureen ; Gaydos, Charlotte A ; Hardick, Justin ; Wood, Billie Jo ; Reznik, Tamara ; Rao, S. P. / Is Chlamydia pneumoniae infection associated with stroke in children with sickle cell disease?. In: Pediatrics. 2004 ; Vol. 113, No. 4.
@article{b7a4ba454b724e9c9f6c37bab4bcd203,
title = "Is Chlamydia pneumoniae infection associated with stroke in children with sickle cell disease?",
abstract = "BACKGROUND: Stroke is often a devastating complication of sickle cell disease (SCD). Most children with SCD-related stroke have stenotic and occlusive disease of cerebral blood vessels due to intimal hyperplasia. This hyperplasia is hypothesized to result from an inflammatory response similar to that in atherosclerosis and has been attributed to infection by Chlamydia pneumoniae. OBJECTIVE: To determine whether C pneumoniae infection is associated with stroke and cerebrovascular disease, including transient ischemic attacks and abnormal transcranial Doppler examinations, in children with SCD. METHODS: Children with SCD on chronic transfusion due to a history of stroke, transient ischemic attack, or abnormal transcranial Doppler; children with SCD without stroke; healthy controls; and children being transfused for other reasons were enrolled. Peripheral blood and nasopharyngeal (NP) swab specimens were collected from all patients. In patients on transfusion, pretransfusion specimens and samples from the unit of packed red blood cells being transfused were obtained. Peripheral blood monocytic cells (PBMCs) and NP swab specimens were cultured for C pneumoniae in HEp-2 cells. C pneumoniae polymerase chain reaction was performed on PBMCs with a nested touch-down method with primers from the omp-1gene (in duplicate) and a second real-time polymerase chain reaction by using 16S ribosomal RNA primers. RESULTS: C pneumoniae DNA was detected in the PBMCs of 1 of 14 (7.1{\%}) children with SCD on chronic transfusion, 1 of 10 (10{\%}) sickle cell controls, 1 of 10 (10{\%}) healthy controls, and none of the 5 children receiving chronic transfusion for other reasons. It was not detected in specimens from transfusion units. One child with SCD and stroke, 1 sickle cell control, and 1 transfusion control had positive NP cultures for C pneumoniae. C pneumoniae DNA was not detected in their PBMCs, and all 3 children were asymptomatic. C pneumoniae was not detected by culture of PBMCs from any of the patients after 7 passages. CONCLUSION: Stroke in children with SCD does not seem to be associated with C pneumoniae infection in our population.",
author = "Meenakshi Goyal and Miller, {Scott T.} and Hammerschlag, {Margaret R.} and Maureen Gelling and Gaydos, {Charlotte A} and Justin Hardick and Wood, {Billie Jo} and Tamara Reznik and Rao, {S. P.}",
year = "2004",
month = "4",
language = "English (US)",
volume = "113",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "4",

}

TY - JOUR

T1 - Is Chlamydia pneumoniae infection associated with stroke in children with sickle cell disease?

AU - Goyal, Meenakshi

AU - Miller, Scott T.

AU - Hammerschlag, Margaret R.

AU - Gelling, Maureen

AU - Gaydos, Charlotte A

AU - Hardick, Justin

AU - Wood, Billie Jo

AU - Reznik, Tamara

AU - Rao, S. P.

PY - 2004/4

Y1 - 2004/4

N2 - BACKGROUND: Stroke is often a devastating complication of sickle cell disease (SCD). Most children with SCD-related stroke have stenotic and occlusive disease of cerebral blood vessels due to intimal hyperplasia. This hyperplasia is hypothesized to result from an inflammatory response similar to that in atherosclerosis and has been attributed to infection by Chlamydia pneumoniae. OBJECTIVE: To determine whether C pneumoniae infection is associated with stroke and cerebrovascular disease, including transient ischemic attacks and abnormal transcranial Doppler examinations, in children with SCD. METHODS: Children with SCD on chronic transfusion due to a history of stroke, transient ischemic attack, or abnormal transcranial Doppler; children with SCD without stroke; healthy controls; and children being transfused for other reasons were enrolled. Peripheral blood and nasopharyngeal (NP) swab specimens were collected from all patients. In patients on transfusion, pretransfusion specimens and samples from the unit of packed red blood cells being transfused were obtained. Peripheral blood monocytic cells (PBMCs) and NP swab specimens were cultured for C pneumoniae in HEp-2 cells. C pneumoniae polymerase chain reaction was performed on PBMCs with a nested touch-down method with primers from the omp-1gene (in duplicate) and a second real-time polymerase chain reaction by using 16S ribosomal RNA primers. RESULTS: C pneumoniae DNA was detected in the PBMCs of 1 of 14 (7.1%) children with SCD on chronic transfusion, 1 of 10 (10%) sickle cell controls, 1 of 10 (10%) healthy controls, and none of the 5 children receiving chronic transfusion for other reasons. It was not detected in specimens from transfusion units. One child with SCD and stroke, 1 sickle cell control, and 1 transfusion control had positive NP cultures for C pneumoniae. C pneumoniae DNA was not detected in their PBMCs, and all 3 children were asymptomatic. C pneumoniae was not detected by culture of PBMCs from any of the patients after 7 passages. CONCLUSION: Stroke in children with SCD does not seem to be associated with C pneumoniae infection in our population.

AB - BACKGROUND: Stroke is often a devastating complication of sickle cell disease (SCD). Most children with SCD-related stroke have stenotic and occlusive disease of cerebral blood vessels due to intimal hyperplasia. This hyperplasia is hypothesized to result from an inflammatory response similar to that in atherosclerosis and has been attributed to infection by Chlamydia pneumoniae. OBJECTIVE: To determine whether C pneumoniae infection is associated with stroke and cerebrovascular disease, including transient ischemic attacks and abnormal transcranial Doppler examinations, in children with SCD. METHODS: Children with SCD on chronic transfusion due to a history of stroke, transient ischemic attack, or abnormal transcranial Doppler; children with SCD without stroke; healthy controls; and children being transfused for other reasons were enrolled. Peripheral blood and nasopharyngeal (NP) swab specimens were collected from all patients. In patients on transfusion, pretransfusion specimens and samples from the unit of packed red blood cells being transfused were obtained. Peripheral blood monocytic cells (PBMCs) and NP swab specimens were cultured for C pneumoniae in HEp-2 cells. C pneumoniae polymerase chain reaction was performed on PBMCs with a nested touch-down method with primers from the omp-1gene (in duplicate) and a second real-time polymerase chain reaction by using 16S ribosomal RNA primers. RESULTS: C pneumoniae DNA was detected in the PBMCs of 1 of 14 (7.1%) children with SCD on chronic transfusion, 1 of 10 (10%) sickle cell controls, 1 of 10 (10%) healthy controls, and none of the 5 children receiving chronic transfusion for other reasons. It was not detected in specimens from transfusion units. One child with SCD and stroke, 1 sickle cell control, and 1 transfusion control had positive NP cultures for C pneumoniae. C pneumoniae DNA was not detected in their PBMCs, and all 3 children were asymptomatic. C pneumoniae was not detected by culture of PBMCs from any of the patients after 7 passages. CONCLUSION: Stroke in children with SCD does not seem to be associated with C pneumoniae infection in our population.

UR - http://www.scopus.com/inward/record.url?scp=2342583394&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2342583394&partnerID=8YFLogxK

M3 - Article

VL - 113

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 4

ER -