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Abnormal transcranial Döppler ultrasonography in children with sickle cell disease
Ana Claudia Celestino Bezerra Leite1, Raquel Vasconcellos Carvalhaes de Oliveira, Patrícia Gomes de Moura
1Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti - Hemorio, Rio de Janeiro, RJ, Brazil ; Instituto de Pesquisa Clínica Evandro Chagas - IPEC, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, RJ, Brazil.
Insights
Abnormal transcranial Doppler results in children with sickle cell disease indicate a higher stroke risk. This confirms the value of transcranial Doppler screening for early detection and prevention in this vulnerable population.
Area of Science:
- Pediatric Hematology
- Neurology
- Vascular Medicine
Background:
- Stroke is a significant risk in children (2-16 years) with sickle cell disease.
- Transcranial Doppler (TCD) is a recommended screening tool for stroke risk in this population.
Purpose of the Study:
- To correlate TCD findings with stroke-related complications in pediatric sickle cell disease.
- To analyze baseline characteristics of patients in relation to TCD results and complications.
Main Methods:
- Observational study involving 902 children and adolescents (2-16 years) with sickle cell disease across three centers.
- Data collected from January 2008 to July 2009.
- Transcranial Doppler (TCD) performed on 773 patients, primarily for screening (91.2%).
Main Results:
- 28.6% of patients experienced at least one sickle cell disease complication.
- Conditional or abnormal TCD results were significantly more frequent in patients with complications (OR=3.18) and abnormal lab results (OR=4.03).
- A median age of 6.5 years, with 74.4% having hemoglobin SS.
Conclusions:
- Abnormal TCD results are significantly associated with complications in pediatric sickle cell disease patients.
- This finding supports the use of TCD as a crucial screening test for identifying high-risk individuals.
- Reinforces TCD screening for all sickle cell disease patients aged 2-16 years to mitigate stroke risk.
Background:
Stroke is a potentially fatal complication of sickle cell disease in children between 2-16 years and transcranial Döppler has been recommended as a screening method in these cases.
Objective:
The main goal of this study was to correlate transcranial Döppler results to complications related to stroke in sickle cell disease and baseline characteristics of the population.
Methods:
This was an observational study of children and adolescents with ages between 2-16 years with sickle cell disease who were followed in three centers.
Results:
From January 2008 to July 2009, 902 patients were enrolled in this study. The median age was 6.5 years (range: 1.8-15.8), 52.3% were male, 74.4% had hemoglobin SS; 221 (28.6%) had at least one complication associated with sickle cell disease. A total of 773 patients performed transcranial Döppler; in 91.2% this was a method of screening. Conditional or abnormal transcranial Döppler results were more common in patients with sickle cell disease complications versus those without complications (ODDS ratio = 3.18; 95% Confidence interval = 1.92-5.27). There was a significant difference in the frequency of conditional or abnormal transcranial Döppler results in patients with abnormal laboratory results compared to those without abnormalities (OR=4.03); 95% confidence interval = 2.30-7.06.
Conclusions:
Conditional or abnormal transcranial Döppler results were significantly more frequent in patients with complications of sickle cell disease confirming the increased risk of stroke in this subgroup of patients. This observation reinforces the recommendation of transcranial Döppler as a screening test for all patients with sickle cell disease with ages between 2 and 16 years.
