Cerebrospinal fluid (CSF) and serum samples of 20 young adults (mean a
ge 41 +/- 3.4 yr) with a first episode of stroke were tested for inter
leukin-2 (IL-2), soluble interleukin-2 receptor (SIL-2R), tumour necro
sis factor-alpha (TNF-alpha) and interleukin-l-beta (IL-1 beta) levels
. The results were compared to 20 patients who had neurological sympto
ms without evidence of a neurological disease. Three subgroups were fo
rmed according to the aetiological source of the stroke, determined by
the neurological examination and evaluation. In 13 patients, the pres
ence of atheromatous carotid plaque or cardiac disease was found. In f
ive of the patients, stroke was the presenting symptom of systemic lup
us erythematosus (SLE), which developed during the follow-up period. I
n two patients, no obvious aetiology could be demonstrated. The SIL-2R
level was significantly higher in the CSF of patients who later devel
oped definite SLE (P = 0.001). Other CSF interleukins and all serum in
terleukin levels were not significantly different in any of the groups
. No correlation between albumin quotient and CSF SIL-2R was found. Th
e SIL-2R level in the CSF may be used as a diagnostic tool to differen
tiate immunologically mediated vascular processes in the CNS from stro
ke of other origin.