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Stroke in sickle cell anemia: alternative etiologies
Michael M Dowling1, Charles T Quinn, Zora R Rogers
1Department of Pediatrics, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9063, USA. Michael.dowling@utsouthwestern.edu
Pediatric Neurology
|July 11, 2009
Summary
Pediatric stroke in sickle cell anemia can stem from traditional causes, not just sickle cell disease itself. This case highlights cardioembolic stroke patterns in a child with sickle cell anemia, emphasizing broader diagnostic considerations.
Area of Science:
- Pediatric Neurology
- Hematology
- Cardiology
Background:
- Stroke is a frequent complication in pediatric sickle cell anemia.
- Traditional stroke causes are often overlooked in these patients.
Observation:
- An 11-year-old girl with sickle cell anemia presented with severe headache.
- She was diagnosed with recurrent bilateral multifocal strokes exhibiting a cardioembolic pattern.
Findings:
- Evaluation revealed a patent foramen ovale, antiphospholipid antibodies, and elevated factor VIII and lipoprotein(a).
- Sickle cell anemia creates a hypercoagulable state and can increase right heart pressures, predisposing to paradoxical embolization.
Implications:
- This case suggests that traditional stroke etiologies should be investigated in children with sickle cell anemia.
- Recognizing these co-existing factors is crucial for accurate diagnosis and management of pediatric stroke in sickle cell disease.
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