NEW findings highlight that underlying rheumatic diseases may play a significant role in ischemic stroke among younger adults, emphasizing the importance of early diagnosis and referral.
In a retrospective study conducted at a tertiary care center, investigators examined 115 patients aged 18 to 65 who experienced their first ischemic stroke and had no prior rheumatologic diagnosis. Of these, 70 were classified as young ischemic stroke cases. Careful review of clinical, laboratory, and imaging data revealed several instances where a hidden rheumatic disease was the underlying cause.
Specifically, diagnoses included systemic lupus erythematosus in association with secondary antiphospholipid syndrome, Sjögren’s syndrome with lupus and secondary antiphospholipid syndrome, primary antiphospholipid syndrome, isolated lupus, primary Sjögren’s syndrome, and granulomatosis with polyangiitis. These findings underscore the diversity of rheumatologic conditions that can present initially as ischemic stroke in younger patients without prior clinical suspicion.
The study authors stress that correct etiologic diagnosis in these cases is crucial, as missed recognition of rheumatic involvement could increase the risk of recurrent ischemic attacks. For practicing clinicians, the results highlight the need to maintain a high index of suspicion for rheumatologic causes when evaluating stroke in younger populations. Referral to rheumatology services, when appropriate, may help secure timely diagnoses and reduce the likelihood of recurrent cerebrovascular events.
Ultimately, this experience reinforces the value of interdisciplinary collaboration in stroke care. Greater awareness among neurologists, internists, and emergency physicians may enhance detection of these less common but clinically significant underlying conditions.
Reference:
Konak HE et al. Rheumatic diseases presenting with young ischemic stroke: Revelations from tertiary center experience. North Clin Istanb. 2025;12(1):103-110.
