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Stroke in a cohort of patients with homozygous sickle cell disease

Stroke in a cohort of patients with homozygous sickle cell disease
Stroke in a cohort of patients with homozygous sickle cell disease
Strokes occurred in 17 of 310 children with homozygous sickle cell disease who were followed from birth, representing an incidence of 7.8% by the age of 14 years. Two children had subarachnoid hemorrhage, one having resolution of symptoms after aneurysm surgery and another dying of a presumed second hemorrhage 14 days later. The remaining 15 strokes were presumed to be cerebral infarction, although autopsy, angiographic, or computed tomographic evidence was available in only 8 children. There were 6 deaths, 2 in the acute event and 4 after recurrence, which occurred in 6 (46%) of 13 patients who survived the initial episode. There were 10 recurrent episodes at a median interval of 9 months after the initial event. Steady-state hematologic data revealed significantly higher leukocyte counts than in control subjects without strokes at age 1 year and in the last study preceding the stroke. The initial stroke coincided with an acutely lowered hemoglobin value in 5 patients (3 aplastic crises, 1 acute splenic sequestration, 1 probable pulmonary sequestration) and with painful crises in another 7 patients. We conclude that a high leukocyte count and an acute decrease of hemoglobin are risk factors for stroke in patients with homozygous sickle cell disease
0022-3476
360-366
Balkaran, B.
67a3ffb8-25f2-49c7-b41f-e8ca188e37aa
Char, G.
91552954-7995-42ad-9223-6fbe1fd1727f
Morris, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe
Thomas, P.W.
7fb3690c-c304-4a3b-864e-bd2415f3db16
Serjeant, B.E.
d6cf580b-27e4-4943-9696-ddf4e51b9999
Serjeant, G.R.
0ee3a15b-b982-4b24-adbf-c1b0ebb65b71
Balkaran, B.
67a3ffb8-25f2-49c7-b41f-e8ca188e37aa
Char, G.
91552954-7995-42ad-9223-6fbe1fd1727f
Morris, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe
Thomas, P.W.
7fb3690c-c304-4a3b-864e-bd2415f3db16
Serjeant, B.E.
d6cf580b-27e4-4943-9696-ddf4e51b9999
Serjeant, G.R.
0ee3a15b-b982-4b24-adbf-c1b0ebb65b71

Balkaran, B., Char, G., Morris, J.S., Thomas, P.W., Serjeant, B.E. and Serjeant, G.R. (1992) Stroke in a cohort of patients with homozygous sickle cell disease. Journal of Pediatrics, 120 (3), 360-366. (PMID:1538280)

Record type: Article

Abstract

Strokes occurred in 17 of 310 children with homozygous sickle cell disease who were followed from birth, representing an incidence of 7.8% by the age of 14 years. Two children had subarachnoid hemorrhage, one having resolution of symptoms after aneurysm surgery and another dying of a presumed second hemorrhage 14 days later. The remaining 15 strokes were presumed to be cerebral infarction, although autopsy, angiographic, or computed tomographic evidence was available in only 8 children. There were 6 deaths, 2 in the acute event and 4 after recurrence, which occurred in 6 (46%) of 13 patients who survived the initial episode. There were 10 recurrent episodes at a median interval of 9 months after the initial event. Steady-state hematologic data revealed significantly higher leukocyte counts than in control subjects without strokes at age 1 year and in the last study preceding the stroke. The initial stroke coincided with an acutely lowered hemoglobin value in 5 patients (3 aplastic crises, 1 acute splenic sequestration, 1 probable pulmonary sequestration) and with painful crises in another 7 patients. We conclude that a high leukocyte count and an acute decrease of hemoglobin are risk factors for stroke in patients with homozygous sickle cell disease

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Published date: 1992
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 365118
URI: http://eprints.soton.ac.uk/id/eprint/365118
ISSN: 0022-3476
PURE UUID: 85a05b59-7b0a-4a68-9a64-97612a7167f9

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Date deposited: 23 May 2014 10:34
Last modified: 11 Dec 2021 04:15

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Contributors

Author: B. Balkaran
Author: G. Char
Author: J.S. Morris
Author: P.W. Thomas
Author: B.E. Serjeant
Author: G.R. Serjeant

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