Neurologic complications following bone marrow transplantation for sickle cell disease.
A boy with sickle cell anemia underwent bone marrow transplantation (BMT). He was normal on neurological examination, but had radiologic evidence of an old left frontal lobe infarct, multiple cerebral vascular stenoses and moyamoya collaterals. After BMT he developed seizures with extension of the infarct and subarachnoid hemorrhage. One year later angiography revealed worsening stenosis of the M1 segments of both middle cerebral arteries. At that time an increase in von Willebrand's factor with decreased large molecular weight multimers (LvWF) was observed. We speculate that LvWF dependent, shear-induced platelet aggregation, together with endothelial damage may have contributed to the development of neurologic complications in this patient.
Abboud
M R
MR
Department of Pediatrics, Medical University of South Carolina, Charleston 29425, USA.
Jackson
S M
SM
Barredo
J
J
Holden
K R
KR
Cure
J
J
Laver
J
J
D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications / Q000628:therapy*; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002561:Cerebrovascular Disorders / Q000097:blood / Q000209:etiology*; D002648:Child; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000097:blood / Q000209:etiology*; D014841:von Willebrand Factor / Q000378:metabolism
D014841:von Willebrand Factor