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Abnormal red blood cell indices increase the risk of arterial ischemic stroke in children

Chaiyos Khongkhatithum1, Praguywan Kadegasem1, Werasak Sasanakul1

  • 1Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|December 24, 2018
PubMed

Insights

High red cell distribution width (RDW) and low mean corpuscular hemoglobin (MCH) levels are risk factors for arterial ischemic stroke (AIS) in children. These red blood cell indices are associated with TM levels, suggesting a link to stroke mechanisms.

Area of Science:

  • Pediatric Neurology
  • Hematology
  • Vascular Biology

Background:

  • Arterial ischemic stroke (AIS) risk is linked to high red cell distribution width (RDW) and low hemoglobin, primarily in adults.
  • The underlying mechanisms connecting these hematological factors to AIS remain largely unknown.
  • This study investigates these associations in a pediatric population.

Purpose of the Study:

  • To determine if red blood cell (RBC) indices, including RDW, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH), are associated with AIS in children.
  • To explore the correlation between RBC indices and TM levels in pediatric AIS patients.

Main Methods:

  • A case-control study involving 90 pediatric AIS patients and 143 healthy controls (HC).
  • Analysis of RBC indices (RDW, MCV, MCH) and their correlation with TM levels.
  • Calculation of odds ratios (ORs) for AIS subtypes based on RBC index thresholds.

Main Results:

  • Elevated RDW (>15%), low MCV (<80 fL), and low MCH (<27 pg) were significantly associated with increased odds of AIS in children without underlying diseases.
  • Specific ORs were found for large vessel (MCV <80 fL: OR 5.4; MCH <27 pg: OR 2.9; RDW >15%: OR 5.5) and small vessel (MCV <80 fL: OR 2.8; MCH <27 pg: OR 2.6; RDW >15%: OR 2.7) AIS subtypes.
  • RBC indices demonstrated significant correlations with TM levels.

Conclusions:

  • Low MCV and MCH levels, along with high RDW, are identified as significant risk factors for pediatric AIS.
  • These RBC indices are associated with TM levels, potentially shedding light on AIS pathogenesis in children.

Keywords:
Arterial ischemic strokeChildrenRed blood cell indices

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