Abnormal transcranial Döppler ultrasonography in children with sickle cell disease

Abstract

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. ConclusionsConditional 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.

Transcranial Doppler velocity among Jamaican children with sickle cell anaemia: determining the significance of haematological values and nutrition

“…In the STOP trial, the prevalence was 9·3% (Adams et al , ) and this proportion did not vary among 14 geographical sites in the US and one in Canada. Our frequency of TCD velocities was higher than those reported from Brazil (4·0%) (Leite et al , ) and Nigeria (4·7%) (Lagunju et al , ), but lower than that recorded in Mali (8·1%) (Dorie et al , ). Although the rate of abnormal TCD velocities was higher in Jamaica than Nigeria, the rate of conditional velocities was lower than in Nigeria, which was 25·3% (Lagunju et al , ).…”

Laboratory and Genetic Biomarkers Associated with Cerebral Blood Flow Velocity in Hemoglobin SC Disease

“…Accordingly, these children presented more pronounced anemia than those with lower TAMMV. Some authors have reported that anemia may pose an additional risk of stroke development in SCA individuals [ 7 , 13 , 25 ]. It has also been suggested that the increased cerebral blood flow and flow velocity associated with chronic anemia can cause disturbances in blood flow, which may lead to cerebrovascular damage [ 7 , 13 , 25 ].…”

Transcranial Doppler Ultrasound in Peninsular Arab Patients With Sickle Cell Disease

“…Table shows reported transcranial Doppler values from the United States, France, Brazil, Tanzania, Nigeria, and Iran in which the proportions with abnormal values ranged from 1.6% to 20.7%. However, the 2 studies from the Arabian Peninsula (Oman and Kuwait) did not record any abnormal values, whereas the study from Iran reported 3% .…”