Transcranial doppler as screening method for sickling crises in children with sickle cell anemia: a latin America cohort study

dc.contributor.authorModolo, Gabriel Pinheiro [UNESP]
dc.contributor.authorLuvizutto, Gustavo José
dc.contributor.authorHamamoto Filho, Pedro Tadao [UNESP]
dc.contributor.authorBraga, Gabriel Pereira
dc.contributor.authorBazan, Silmeia Garcia Zanati [UNESP]
dc.contributor.authorFerreira, Natalia Cristina [UNESP]
dc.contributor.authorde Souza, Juli Thomaz [UNESP]
dc.contributor.authorWinckler, Fernanda Cristina [UNESP]
dc.contributor.authorMacedo de Freitas, Carlos Clayton [UNESP]
dc.contributor.authorHokama, Newton Key [UNESP]
dc.contributor.authorVidal, Edison Iglesias de Oliveira [UNESP]
dc.contributor.authorBazan, Rodrigo [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionUniversidade Federal Do Triângulo Mineiro (UFTM)
dc.contributor.institutionUniversidade Federal de Mato Grosso do Sul (UFMS)
dc.description.abstractBackground: 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.en
dc.description.affiliationDepartmento de Neurologia Psicologia e Psiquiatria Universidade Estadual Paulista (UNESP)
dc.description.affiliationDepartmento de Fisioterapia Aplicada Universidade Federal Do Triângulo Mineiro (UFTM), Minas Gerais
dc.description.affiliationFaculdade de Medicina Universidade Federal de Mato Grosso Do Sul (UFMS), Mato Grosso Do Sul
dc.description.affiliationDepartamento de Clínica Médica Universidade Estadual Paulista (UNESP)
dc.description.affiliationUnespDepartmento de Neurologia Psicologia e Psiquiatria Universidade Estadual Paulista (UNESP)
dc.description.affiliationUnespDepartamento de Clínica Médica Universidade Estadual Paulista (UNESP)
dc.identifier.citationBMC Pediatrics, v. 22, n. 1, 2022.
dc.relation.ispartofBMC Pediatrics
dc.subjectSickle cell anemia
dc.subjectTranscranial Doppler
dc.titleTranscranial doppler as screening method for sickling crises in children with sickle cell anemia: a latin America cohort studyen