Priapismo em crianças: revisão de fisiopatologia e tratamento

Jesus, Lisieux Eyer de; Dekermacher, Samuel

doi:10.1590/s0021-75572009000300003

Cited by 20 publications

(5 citation statements)

References 43 publications

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“…Because the median age of the patients studied was 24 years and because of the significant relationship between the occurrence of priapism and older age, it might not be surprising that sexual arousal/ intercourse has been noted in previous studies to be of aetiological importance [ 13 , 16 ]. It is noteworthy that studies have shown that the incidence tends to plateau as patients approach 30 years of age and beyond [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…The observed lack of an association with platelet counts and Hb concentration may be partly explained by the fact that transfusion and drugs like hydroxycarbamide (aimed at increasing the Hb concentration and reducing the platelet count) have not been very effective in the treatment or prophylaxis of this condition [ 13 , 19 ]. This is evidenced both by clinical experience and by the report by Adeyoju et al [ 13 ], which showed that analgesia, rehydration and possibly exchange blood transfusion were the preferred treatment modalities amongst physicians [ 13 , 16 , 20 ]. However, exchange blood transfusion, aimed at reducing the HbS percentage as well as improving haematocrit levels, does not usually yield satisfactory results [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Priapism in Homozygous Sickle Cell Patients: Important Clinical and Laboratory Associations

Madu¹,

Ubesie

Ocheni³

et al. 2014

Med Princ Pract

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Objective: To evaluate the relationship between the occurrence of priapism and important steady-state clinical and laboratory parameters in homozygous sickle cell disease (SCD). Subjects and Methods: Steady-state clinical and laboratory data were obtained from the medical records of 126 male patients seen in the clinic over a 7-year period. Estimated prevalence rates, correlation coefficients and independent t tests were calculated to assess the relationship between priapism and several important clinical and laboratory indices. Patient data on age, haemoglobin concentrations, the frequency of crises per annum, leucocyte counts, platelet counts, serum bilirubin and aspartate transaminase were evaluated. Results: The prevalence of priapism was determined to be 21.4%, and 22.2% of those affected had erectile dysfunction. There was a significant positive correlation between priapism and older age (p = 0.049) and lower leucocyte counts (p = 0.008). There was no significant relationship with other clinical or laboratory indices. Conclusion: About 1 in 4 of all homozygous older SCD patients had priapism, and an approximately similar ratio developed erectile dysfunction; they also had lower steady-state leucocyte counts. Other clinical and laboratory indicators of disease severity in SCD did not positively correlate with the occurrence of priapism, and this may imply an alternative pathogenetic mechanism.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Priapism in Homozygous Sickle Cell Patients: Important Clinical and Laboratory Associations

Madu¹,

Ubesie

Ocheni³

et al. 2014

Med Princ Pract

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“…Leg ulcers are the most frequent cutaneous manifestation of SCD, which may contribute to morbidity, with an incidence of 25% to 75% among affected patients [ 9 , 10 ]. Priapism is one of the less well characterized complications of the SCD disorder [ 11 ], with a prevalence of 2–6% in paediatric sickle-cell clinics [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Elevated Proangiogenic Markers are Associated with Vascular Complications within Ghanaian Sickle Cell Disease Patients

et al. 2018

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Sickle cell disease (SCD) is an inherited blood disorder that can result in vasculopathy and end organ damage. Angiogenesis has been implicated as a key contributing factor to vascular mediated tissue injury in SCD. The relative plasma levels of angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), and vascular endothelial growth factor (VEGF) greatly influence angiogenesis. Dysregulation of these growth factors, leading to a pro-angiogenic state in SCD patients, has been documented in the developed world but there is very little data in Africa. There is the need, therefore, for studies in Ghanaian SCD patients. The aim of this study was to assess plasma levels of Ang-1, Ang-2, and VEGF in homozygous (HbSS) SCD patients with or without complications and healthy controls (HbAA) in Ghana. The study was a case-control study involving 544 participants: 396 HbSS SCD patients and 148 HbAA healthy controls. The study was conducted at the Center for Clinical Genetics (Sickle Cell Clinic) and Accra Area Blood Centre for National Blood transfusion at the Korle-Bu Teaching Hospital, Accra, Ghana. The plasma levels of Ang-1, Ang-2, and VEGF of study participants were measured with a double sandwich enzyme-linked immunosorbent assay (ELISA) technique. Complete blood count (CBC) was measured with an autoanalyser. The mean plasma Ang-1, Ang-2, and VEGF were significantly higher in HbSS SCD patients with or without complications than healthy controls (p < 0.001). The Ang-2/Ang-1 ratio was significantly lower in the controls than the HbSS patients (p < 0.001). The Ang-2/Ang-1 ratio was higher in the HbSS patients with leg ulcers as compared with patients with other complications and healthy controls (p < 0.001). There were higher leucocyte counts in HbSS patients than healthy controls. Overall, there was elevated plasma levels of Ang-1, Ang-2, and VEGF in SCD patients. The higher Ang-2/Ang-1 plasma levels in patients with leg ulcers suggests a possible ongoing angiogenesis and response to inflammatory stimuli. The study provides a first report on plasma levels of angiopoietin-1, angiopoietin-2, and vascular endothelial growth factors in homozygous sickle cell disease patients in Ghana.

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“…3, 8 Interestingly, we found that there was a significant decline in the number of admissions for SCD-related priapism (0.8% to 0.4%, p<0.001 for trend), but not for the number of individual patients diagnosed with SCD-related priapism (~2% throughout the study period, p=0.34 for trend). Rates of priapism diagnoses and admissions in males with SCD varied widely among PHIS hospitals.…”

Section: Discussionmentioning

confidence: 67%

Trends in Sickle Cell Disease-related Priapism in U.S. Children's Hospitals

Wang

Herbst

Rothman

et al. 2016

Urology

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Objective To define rates of priapism diagnosis and inpatient admission among males with SCD. Methods We retrospectively reviewed the Pediatric Health Information System database for males aged <21 years treated 2004-2012. We identified patients with SCD and priapism based on ICD-9-CM diagnosis codes. Logistic regression and generalized estimating equation models were used to control for confounding and to adjust for within-hospital clustering of similar patients. Results We identified 17,186 males who were admitted 137,710 times during the study period. Of these, 362 (2.1%) were diagnosed with priapism on 748 admissions. There was a significant decrease in the number of priapism admissions among patients with SCD over time (0.81% in 2004 to 0.44% in 2012, p<0.001). The number of patients diagnosed with SCD-related priapism varied over time without a statistically significant trend (2.3% in 2004, 2.69% in 2008, 1.01% in 2012, p=0.34). Rates of priapism admissions (0-4.4%) varied widely between hospitals. Older patient age was associated with an increased likelihood of a priapism admission in the multivariate logistic regression model after adjusting for treatment year, hospital region, and for hospital-level clustering of similar patients. Conclusions From 2004-2012, the number of admissions for SCD-related priapism declined while the number of individual patients diagnosed with SCD-related priapism did not. Rates of priapism-related admissions in males with SCD vary widely among PHIS hospitals.

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Priapismo em crianças: revisão de fisiopatologia e tratamento

Cited by 20 publications

References 43 publications

Priapism in Homozygous Sickle Cell Patients: Important Clinical and Laboratory Associations

Priapism in Homozygous Sickle Cell Patients: Important Clinical and Laboratory Associations

Elevated Proangiogenic Markers are Associated with Vascular Complications within Ghanaian Sickle Cell Disease Patients

Trends in Sickle Cell Disease-related Priapism in U.S. Children's Hospitals

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