Transcranial doppler as screening method for sickling crises in children with sickle cell anemia: a latin America cohort study
Abstract Background Sickle cell anemia (SCA) is the leading cause of childhood stroke. We aimed to evaluate whether altered cerebral flow velocities, as measured by transcranial Doppler (TCD), are associated with vaso-occlusive complications in addition to stroke in pediatric SCA patients. Methods W...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-022-03429-5 |
| _version_ | 1811328719920300032 |
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| author | Gabriel Pinheiro Modolo Gustavo José Luvizutto Pedro Tadao Hamamoto Filho Gabriel Pereira Braga Silmeia Garcia Zanati Bazan Natalia Cristina Ferreira Juli Thomaz de Souza Fernanda Cristina Winckler Carlos Clayton Macedo de Freitas Newton Key Hokama Edison Iglesias de Oliveira Vidal Rodrigo Bazan |
| author_facet | Gabriel Pinheiro Modolo Gustavo José Luvizutto Pedro Tadao Hamamoto Filho Gabriel Pereira Braga Silmeia Garcia Zanati Bazan Natalia Cristina Ferreira Juli Thomaz de Souza Fernanda Cristina Winckler Carlos Clayton Macedo de Freitas Newton Key Hokama Edison Iglesias de Oliveira Vidal Rodrigo Bazan |
| author_sort | Gabriel Pinheiro Modolo |
| collection | DOAJ |
| description | Abstract Background Sickle cell anemia (SCA) is the leading cause of childhood stroke. We aimed to evaluate whether altered cerebral flow velocities, as measured by transcranial Doppler (TCD), are associated with vaso-occlusive complications in addition to stroke in pediatric SCA patients. Methods We evaluated 37 children aged between 2 and 16 years with SCA who underwent screening for TCD between January 2012 and October 2018. Genotypic profiles and demographic data were collected, TCD examinations were performed during follow-up, and the presence of sickling crises was compared. Survival analyses were performed using simple frailty models, in which each predictor variable was analyzed separately in relation to the occurrence of a sickling crisis. Results The variables related to sickle cell crises in the univariate analysis were peak systolic velocity (PSV) in the middle cerebral artery (MCA), hazard ratio (HR) 1.01 (1.00—1.02) p = 0.04; end-diastolic velocity (EDV) in the MCA, HR 1.02 (1.01—1.04) p = 0.01; time average mean maximum velocity (TAMMV) in the basilar artery (BA), HR 1.02 (1.00—1.04) p = 0.04; hemoglobin, HR 0.49 (0.38—0.65) p < 0.001; hematocrit, HR 0.78 (0.71—0.85) p < 0.001; leukocyte counts, HR 1.1 (1.05—1.15) p < 0.001; platelets counts, HR 0.997 (0.994—0.999) p = 0.02; and reticulocyte numbers, HR 1.14 (1.06—1.23) p < 0.001. Conclusions Our results indicate PSV and EDV in the MCA and TAMMV in the BA as markers of risk for the occurrence of sickling crises in SCA. |
| first_indexed | 2024-04-13T15:30:05Z |
| format | Article |
| id | doaj.art-6e9a66e85e994d58bbd38379e1248e52 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-04-13T15:30:05Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-6e9a66e85e994d58bbd38379e1248e522022-12-22T02:41:24ZengBMCBMC Pediatrics1471-24312022-06-012211810.1186/s12887-022-03429-5Transcranial doppler as screening method for sickling crises in children with sickle cell anemia: a latin America cohort studyGabriel Pinheiro Modolo0Gustavo José Luvizutto1Pedro Tadao Hamamoto Filho2Gabriel Pereira Braga3Silmeia Garcia Zanati Bazan4Natalia Cristina Ferreira5Juli Thomaz de Souza6Fernanda Cristina Winckler7Carlos Clayton Macedo de Freitas8Newton Key Hokama9Edison Iglesias de Oliveira Vidal10Rodrigo Bazan11Departmento de Neurologia, Psicologia e Psiquiatria, Universidade Estadual Paulista (UNESP)Departmento de Fisioterapia Aplicada, Universidade Federal Do Triângulo Mineiro (UFTM)Departmento de Neurologia, Psicologia e Psiquiatria, Universidade Estadual Paulista (UNESP)Faculdade de Medicina, Universidade Federal de Mato Grosso Do Sul (UFMS)Departamento de Clínica Médica, Universidade Estadual Paulista (UNESP)Departmento de Neurologia, Psicologia e Psiquiatria, Universidade Estadual Paulista (UNESP)Departmento de Neurologia, Psicologia e Psiquiatria, Universidade Estadual Paulista (UNESP)Departmento de Neurologia, Psicologia e Psiquiatria, Universidade Estadual Paulista (UNESP)Departmento de Neurologia, Psicologia e Psiquiatria, Universidade Estadual Paulista (UNESP)Departamento de Clínica Médica, Universidade Estadual Paulista (UNESP)Departamento de Clínica Médica, Universidade Estadual Paulista (UNESP)Departmento de Neurologia, Psicologia e Psiquiatria, Universidade Estadual Paulista (UNESP)Abstract Background Sickle cell anemia (SCA) is the leading cause of childhood stroke. We aimed to evaluate whether altered cerebral flow velocities, as measured by transcranial Doppler (TCD), are associated with vaso-occlusive complications in addition to stroke in pediatric SCA patients. Methods We evaluated 37 children aged between 2 and 16 years with SCA who underwent screening for TCD between January 2012 and October 2018. Genotypic profiles and demographic data were collected, TCD examinations were performed during follow-up, and the presence of sickling crises was compared. Survival analyses were performed using simple frailty models, in which each predictor variable was analyzed separately in relation to the occurrence of a sickling crisis. Results The variables related to sickle cell crises in the univariate analysis were peak systolic velocity (PSV) in the middle cerebral artery (MCA), hazard ratio (HR) 1.01 (1.00—1.02) p = 0.04; end-diastolic velocity (EDV) in the MCA, HR 1.02 (1.01—1.04) p = 0.01; time average mean maximum velocity (TAMMV) in the basilar artery (BA), HR 1.02 (1.00—1.04) p = 0.04; hemoglobin, HR 0.49 (0.38—0.65) p < 0.001; hematocrit, HR 0.78 (0.71—0.85) p < 0.001; leukocyte counts, HR 1.1 (1.05—1.15) p < 0.001; platelets counts, HR 0.997 (0.994—0.999) p = 0.02; and reticulocyte numbers, HR 1.14 (1.06—1.23) p < 0.001. Conclusions Our results indicate PSV and EDV in the MCA and TAMMV in the BA as markers of risk for the occurrence of sickling crises in SCA.https://doi.org/10.1186/s12887-022-03429-5StrokeSickle cell anemiaTranscranial Doppler |
| spellingShingle | Gabriel Pinheiro Modolo Gustavo José Luvizutto Pedro Tadao Hamamoto Filho Gabriel Pereira Braga Silmeia Garcia Zanati Bazan Natalia Cristina Ferreira Juli Thomaz de Souza Fernanda Cristina Winckler Carlos Clayton Macedo de Freitas Newton Key Hokama Edison Iglesias de Oliveira Vidal Rodrigo Bazan Transcranial doppler as screening method for sickling crises in children with sickle cell anemia: a latin America cohort study BMC Pediatrics Stroke Sickle cell anemia Transcranial Doppler |
| title | Transcranial doppler as screening method for sickling crises in children with sickle cell anemia: a latin America cohort study |
| title_full | Transcranial doppler as screening method for sickling crises in children with sickle cell anemia: a latin America cohort study |
| title_fullStr | Transcranial doppler as screening method for sickling crises in children with sickle cell anemia: a latin America cohort study |
| title_full_unstemmed | Transcranial doppler as screening method for sickling crises in children with sickle cell anemia: a latin America cohort study |
| title_short | Transcranial doppler as screening method for sickling crises in children with sickle cell anemia: a latin America cohort study |
| title_sort | transcranial doppler as screening method for sickling crises in children with sickle cell anemia a latin america cohort study |
| topic | Stroke Sickle cell anemia Transcranial Doppler |
| url | https://doi.org/10.1186/s12887-022-03429-5 |
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