Transcranial Doppler in hemoglobin SC disease |
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Authors: | Camilo Vieira Carolina Nogueira Costa de Oliveira Ludmila Araújo Borges de Figueiredo Rayra Pereira Santiago Corynne Stephanie Ahouefa Adanho Sanzio Silva Santana Caroline Lang Burak Isa Menezes Lyra Marilda Souza Goncalves |
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Affiliation: | 1. Ambulatório Pediátrico de Doen?a Cerebrovascular, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Bahia, Brazil;2. Centro de Pesquisas Gon?alo Moniz, Funda??o Oswaldo Cruz, Bahia, Brazil;3. Universidade Salvador, Bahia, Brazil;4. Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Bahia, Brazil;5. Departamento de Hematologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Bahia, Brazil |
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Abstract: | Background: Stroke is a severe clinical disorder in sickle cell disease (SCD), and few studies have evaluated transcranial Doppler (TCD) flow velocities in hemoglobin SC disease (HbSC). The guidelines for stroke risk are based on evaluations in sickle cell anemia (SCA) or HbS/β thalassemia. Procedure: In this study, we compare cerebral blood flow in patients with SCD stratified by genotypes. A total of 1,664 pediatric patients with SCD underwent TCD velocity screening, and the time‐averaged maximum mean velocity (TAMM) was determined in the middle cerebral artery (MCA), anterior cerebral artery (ACA), and distal intracranial internal carotid artery (ICA). Results: Abnormal velocities were not identified in the ACA; therefore, we only use ICA and MCA velocities. TAMM from the left and right in the ICA and MCA was 134.3 ± 32.0 and 134.4 ± 32.6 cm/s in patients with SCA, and 105.2 ± 20.6 and 104.7 ± 20.0 cm/s in the patients with HbSC, respectively. Mean TAMM between right and left ICA/MCA was 134.5 ± 30.5 cm/s in the SCA group, and 104.9 ± 19.3 cm/s in the HbSC group. Notably, our data show that TCD velocities were significantly lower among the patients with HbSC compared to SCA. TAMM was negatively correlated with hemoglobin and hematocrit in both genotypes. Conclusion: These results suggest that a different cut‐off value for abnormal TCD velocities could be considered for patients with HbSC. Additional studies are warranted to determine the actual risk of stroke in HbSC genotype associated with this possible TCD risk value. |
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Keywords: | hemoglobinopathies neurology and sickle cell sickle cell disease transcranial Doppler ultrasound |
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