scholarly journals Factors associated with growth and blood pressure patterns in children with sickle cell anemia: Silent Cerebral Infarct Multi-Center Clinical Trial cohort

2014 ◽  
Vol 90 (1) ◽  
pp. 2-7 ◽  
Author(s):  
Rachel B. Wolf ◽  
Benjamin R. Saville ◽  
Dionna O. Roberts ◽  
Rachel B. Fissell ◽  
Adetola A. Kassim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Cerebral Infarct ◽  
Factors Associated ◽  
Blood Pressure Patterns ◽  
Silent Cerebral Infarct

scholarly journals Progressive loss of brain volume in children with sickle cell anemia and silent cerebral infarct: A report from the silent cerebral infarct transfusion trial

2018 ◽  
Vol 93 (12) ◽  
pp. E406-E408 ◽  
Author(s):  
Deepika S. Darbari ◽  
Odianosen Eigbire-Molen ◽  
Maria R. Ponisio ◽  
Mikhail V. Milchenko ◽  
Mark J. Rodeghier ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Brain Volume ◽  
Cerebral Infarct ◽  
Progressive Loss ◽  
Silent Cerebral Infarct

scholarly journals Silent cerebral infarct definitions and full-scale IQ loss in children with sickle cell anemia

Neurology ◽  
2017 ◽  
Vol 90 (3) ◽  
pp. e239-e246 ◽  
Author(s):  
Natasha A. Choudhury ◽  
Michael R. DeBaun ◽  
Mark Rodeghier ◽  
Allison A. King ◽  
John J. Strouse ◽  
...  
Keyword(s):  
Linear Regression ◽  
Confidence Interval ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Full Scale ◽  
Cerebral Infarct ◽  
Significant Change ◽  
Definition Of ◽  
Silent Cerebral Infarct

ObjectiveTo evaluate whether application of the adult definition of silent cerebral infarct (SCI) (T2-weighted hyperintensity ≥5 mm with corresponding T1-weighted hypointensity on MRI) is associated with full-scale IQ (FSIQ) loss in children with sickle cell anemia (SCA), and if so, whether this loss is greater than that of the reference pediatric definition of SCI (T2-weighted hyperintensity ≥3 mm in children on MRI; change in FSIQ −5.2 points; p = 0.017; 95% confidence interval [CI] −9.48 to −0.93).MethodsAmong children with SCA screened for SCI in the Silent Cerebral Infarct Transfusion trial, ages 5–14 years, a total of 150 participants (107 with SCIs and 43 without SCIs) were administered the Wechsler Abbreviated Scale of Intelligence. A multivariable linear regression was used to model FSIQ in this population, with varying definitions of SCI independently substituted for the SCI covariate.ResultsThe adult definition of SCI applied to 27% of the pediatric participants with SCIs and was not associated with a statistically significant change in FSIQ (unstandardized coefficient −3.9 points; p = 0.114; 95% CI −8.75 to 0.95), with predicted mean FSIQ of 92.1 and 96.0, respectively, for those with and without the adult definition of SCI.ConclusionsThe adult definition of SCI may be too restrictive and was not associated with significant FSIQ decline in children with SCA. Based on these findings, we find no utility in applying the adult definition of SCI to children with SCA and recommend maintaining the current pediatric definition of SCI in this population.

Low Socioeconomic Status, Not Silent Cerebral Infarcts, Is Associated with Grade Failure in Children with Sickle Cell Anemia.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2254-2254
Author(s):  
Allison A. King ◽  
Keyword(s):  
Socioeconomic Status ◽  
Risk Factor ◽  
Sickle Cell ◽  
Low Socioeconomic Status ◽  
Sickle Cell Anemia ◽  
Cerebral Infarct ◽  
Annual Income ◽  
Cerebral Infarcts ◽  
Grade Failure ◽  
Silent Cerebral Infarct

Abstract Background: Among students with sickle cell anemia (SCA), cerebral infarcts are an established risk factor for poor cognition and academic achievement. We tested the hypothesis that in children with SCA, lower socioeconomic status (SES) is associated with grade failure. Methods: We evaluated the association between the SES as measured by annual income per person in household per year, age of student, gender, medical history and grade failure in children with SCA in 24 sites participating in the Silent Cerebral Infarct Multi-Center Clinical Trial. Results: A total of 404 students were evaluable. The mean age was 9.2 years (range 6–13), 37% had a silent infarct, 15% failed a grade, and 18% had an Individualized Education Plan. SES was divided in tertiles based on annual income/person in the household/year < $5000, $5000–$9999, > $10,000. After adjustment for covariates, the risk of grade failure was 1.4 (95% CI 1.2, 1.6) for each increasing year of age, and 1.9 (95% CI 1.03, 3.5) for male gender. Children from households of the lowest tertile were 4 times more likely to fail a grade than children from the top tertile. A silent cerebral infarct was not associated with grade failure 1.4 (95% CI 0.8, 2.6). No student with a history of grade failure was hospitalized > 3 times per year over the past three years. Conclusion: Among students with SCA, poverty is the greatest risk factor for grade failure; whereas the presence of silent cerebral infarct is not. Targeted strategies to improve educational attainment in students with SCA are needed.

scholarly journals Silent cerebral infarct in sickle cell anemia patients of southern Turkey

2020 ◽  
Vol 50 (8) ◽  
pp. 1887-1893
Author(s):  
Ezgi NAFİLE SAYMAN ◽  
Göksel LEBLEBİSATAN ◽  
Şerife LEBLEBİSATAN ◽  
Kenan BIÇAKÇI ◽  
Yurdanur KILINÇ ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Cerebral Infarct ◽  
Southern Turkey ◽  
Silent Cerebral Infarct

scholarly journals Arterial blood pressure in adult Nigerians with sickle cell anemia

2010 ◽  
Vol 56 (3) ◽  
pp. 326-331 ◽  
Author(s):  
N.I. Oguanobi ◽  
B.J.C. Onwubere ◽  
O.G. Ibegbulam ◽  
S.O. Ike ◽  
B.C. Anisiuba ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Arterial Blood

scholarly journals Thrombospondin-1 and L-selectin are associated with silent cerebral infarct in children with sickle cell anaemia

2013 ◽  
Vol 162 (3) ◽  
pp. 421-424 ◽  
Author(s):  
Lisa M. Faulcon ◽  
Zongming Fu ◽  
Pratima Dulloor ◽  
Emily Barron-Casella ◽  
William Savage ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anaemia ◽  
Cerebral Infarct ◽  
Thrombospondin 1 ◽  
Silent Cerebral Infarct

scholarly journals Randomization is not associated with socio-economic and demographic factors in a multi-center clinical trial of children with sickle cell anemia

2014 ◽  
Vol 61 (9) ◽  
pp. 1529-1535 ◽  
Author(s):  
Dionna O. Roberts ◽  
Brittany Covert ◽  
Mark J. Rodeghier ◽  
Nagina Parmar ◽  
Michael R. DeBaun ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Demographic Factors

scholarly journals Greater Change of Orthostatic Blood Pressure Is Related to Silent Cerebral Infarct and Cardiac Overload in Hypertensive Subjects

2004 ◽  
Vol 27 (4) ◽  
pp. 235-241 ◽  
Author(s):  
Kazuo EGUCHI ◽  
Kazuomi KARIO ◽  
Satoshi HOSHIDE ◽  
Yoko HOSHIDE ◽  
Joji ISHIKAWA ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cerebral Infarct ◽  
Orthostatic Blood Pressure ◽  
Silent Cerebral Infarct

Risk Factors for Intracranial Hemorrhage in Children with Sickle Cell Anemia.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1657-1657
Author(s):  
John J. Strouse ◽  
Michael R. DeBaun ◽  
James F. Casella
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Ischemic Stroke ◽  
Steady State ◽  
Sickle Cell ◽  
Intracranial Hemorrhage ◽  
Sickle Cell Anemia ◽  
Small Sample ◽  
Acute Chest Syndrome ◽  
Corticosteroid Administration

Background: Intracranial hemorrhage (ICH) is an uncommon, but devastating, complication of sickle cell disease (SCD) with mortality from 30 to 65%. Most reported cases are in adults; little is known about children. Proposed risk factors include previous ischemic stroke, aneurysms, low steady-state hemoglobin, high steady-state leukocyte count, acute chest syndrome, and hypertransfusion. Methods: Retrospective case-control study designed to characterize and evaluate risk factors for ICH among children with SCD age < 19 years hospitalized at Johns Hopkins Children’s Center from January 1979 to March 2004. Cases had SCD and ICH (intraparenchymal (IPH), subarachnoid (SAH), or intraventricular (IVH) hemorrhage confirmed by neuroimaging or analysis of cerebrospinal fluid; traumatic subdural and epidural hemorrhages were excluded). Controls had SCD and ischemic stroke (focal neurological deficits with corresponding cerebral infarcts by neuroimaging). Both were identified by searching the hospital discharge database using ICD-9 codes for acute stroke and SCD and reviewing the Division of Pediatric Hematology’s records. ACS was defined as a new pulmonary infiltrate and two of the following: chest or rib pain, dyspnea, fever, tachypnea, grunting, nasal flaring, or retractions. Blood pressure was adjusted for age, sex, and hemoglobin genotype. Results: We identified 7 cases (mean age=11.2 years, range 2 to 16 years) and 9 controls (mean age 6.2 years, range 2 to 8 years). As expected, cases were significantly older than controls (p<0.01). All cases and controls had sickle cell anemia. Cases presented with impaired mental status (5/7), bradycardia (5/7), headache (4/7), and emesis (3/7). They often had multiple sites of hemorrhage (5/7) and died during the initial hospitalization (4/7). Five had IPH involving the frontal, parietal, and/or temporal lobes (2 of the patients with IPH also had SAH, 1 had IVH and 1 had both SAH and IVH). Two additional patients had SAH (one also with IVH). Most cases and controls had elevated systolic blood pressure at the time of stroke (4/7 cases, 8/9 controls). Cases had lower steady-state hemoglobin (mean±SE 7.1±0.3 g/dl vs. 7.7±0.4 g/dl), lower steady-state blood pressures (systolic 104±9 vs. 117±5 mm Hg, diastolic 50±5 vs. 61±5 mm Hg) and higher steady-state leukocyte counts (16,590±2823/ul vs. 13,851±2184/ul) than controls, but these differences were not statistically significant. Mean hemoglobin concentration was increased 2.8 g/dl (39.9%) from steady-state at the time of stroke in cases and was unchanged in controls (p=0.08). Other events in the two weeks before ICH associated with increased odds of ICH included transfusion (simple in 5 cases, erythrocytapheresis in 1), ACS (3 cases), and corticosteroid administration (high-dose dexamethasone for ACS in 2, stress doses for possible adrenal insufficiency in 1). Conclusions: In this group of children with SCD, ICH was associated with antecedent events including transfusion and possibly corticosteroids. Mortality was similar to that of adults with SCD and ICH. Limitations of this study include the small sample size and the retrospective design. The contribution of antecedent events to ICH in children with SCD deserves further evaluation. Odds Ratios of Intracranial Hemorrhage For Events in the Last 14 Days Event Odds Ratio (95% CI) P-value Transfusion 48 (1.8-2469) <0.01 ACS 6 (0.3-33) 0.26 Corticosteroids ∞ (1.3- ∞) 0.06

Elevated Systolic Blood Pressure and Low Fetal Hemoglobin Are Risk Factors for Silent Cerebral Infarcts in Children with Sickle Cell Anemia.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 262-262
Author(s):  
Sharada A. Sarnaik ◽  
James F. Casella ◽  
Bruce A Barton ◽  
Michele Afif ◽  
Gladstone Airewele ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Conflicts Of Interest ◽  
Beta Thalassemia ◽  
Cerebral Infarcts ◽  
Hemoglobin F ◽  
Elevated Systolic Blood Pressure

Abstract Abstract 262 Introduction: The most common cause of neurological injury in sickle cell anemia is silent cerebral infarcts (SCI). In the Silent Cerebral Infarct Multi-Center Clinical Trial (SIT Trial) cohort, we sought to identify risk factors associated with SCI. Patients and Methods: In this cross-sectional study, we evaluated the clinical history, baseline laboratory values and performed magnetic resonance imaging of the brain. For those children with SCI-like lesions, a pediatric neurologist examined the child and neuroradiology and neurology committees adjudicated the presence of SCI. Children between the ages of 5 and 15 years with hemoglobin SS or S-beta° thalassemia and no history of overt strokes or seizure were evaluated. Results: A total of 542 children were evaluated; 173 (31.9%) had SCI. The mean age of the children was 9.3 years, with 280 males (51.7%). In a multivariate logistic analysis, two covariates were significant: a single systolic blood pressure (SBP) obtained during a baseline well-visit, p = 0.015 and hemoglobin F (Hgb F) level obtained after three years of age, p = 0.038. Higher values of SBP and lower values of Hgb F increased the odds of SCI; Figure. Baseline values of white blood cell count, hemoglobin level, oxygen saturation, reticulocytes, pain, or ACS event rates were not associated with SCI. Conclusion: SBP and Hgb F level are two previously unidentified risk factors for SCI in children with sickle cell disease. Modulation of SBP and Hgb F levels might decrease the risk of SCI. Disclosures: No relevant conflicts of interest to declare.

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