Excess Interleukin-6 Production and Multiple Ischemic Strokes – What is the Link?

Case Report

Austin J Clin Neurol 2017; 4(4): 1115.

Excess Interleukin-6 Production and Multiple Ischemic Strokes – What is the Link?

Boehme C, Zangerle A, Mayer L, Toell T, Knoflach M, Willeit J and Kiechl S*

Department of Neurology, Medical University Innsbruck, Austria

*Corresponding author: Kiechl S, Department of Neurology, Medical University Innsbruck, Anichstrasse 35, Innsbruck, A-6020 Austria

Received: June 01, 2017; Accepted: June 26, 2017; Published: July 11, 2017


Clinicians often have to deal with rare causes of stroke. We report the case of a 42-year old woman with a 3-year history of unclassified rheumatic disease and elevated level of interleukin-6 (IL-6), who suffered multiple ischemic strokes with an embolic pattern (MRI). Echocardiography revealed a mass in the left atrium suspicious for cardiac myxoma. The patient underwent surgery and recovered quickly. Histopathological examination confirmed the diagnosis of cardiac myxoma and full clinical remission was achieved after a period of four months.

Cardiac myxoma is the most common cardiac tumor and well known for ectopic IL-6-production resulting in rheumatic complaints. Clinicians should be aware that elevated IL-6 levels in the context with history of rheumatic diseases points to cardiac myxoma and should perform echocardiography before complications like stroke emerge.

Keywords: Stroke; IL-6; Cardiac myxoma; Embolic stroke; Interleukin 6


ANA: Antinuclear Antibodies; ANCA: Anti-Neutrophil Cytoplasmatic Antibodies; IL-6: Interleukin 6

Case Presentation

A 42-year-old woman was admitted to our department because of vertigo, numbness of the left face and cold paraesthesia of the right leg. Neurological examination additionally revealed hemiataxia of the left extremities and Horner’s Syndrome leading to the clinical diagnosis of left-sided Wallenberg’s Syndrome. Cerebral MRI demonstrated micro-embolic infarcts in multiple vessel territories along with the clinically leading stroke in the left dorso-lateral medulla oblongata (Figure 1). She had fever up to 38°C without clinical evidence of infection and showed prominent livedo racemosa involving the lower arms and legs (Figure 2). Electrocardiogram and chest X-ray were unremarkable.