Silent infarcts in young children with sickle cell disease.
Silent infarcts have been reported most commonly in school-aged children with homozygous sickle cell disease (SCD-SS) and are associated with neurocognitive deficits. However, the prevalence of silent infarcts in younger children with SCD-SS is not well defined. In this retrospective study, brain magnetic resonance imaging and angiography (MRI/A) studies performed before 6 years of age in a cohort of children with SCD-SS were analysed and the prevalence of abnormalities was calculated. Clinical and laboratory parameters were compared between the groups with and without silent infarcts. Sixty-eight of 96 children in the cohort had brain MRI/A performed prior to age 6 years. Of the 65 who were neurologically asymptomatic, 18 (27.7%, 95% CI 17.3-40.2%) had silent infarcts (mean age 3.7 +/- 1.1 years, range 1.3-5.9 years). Factors associated with silent infarcts included cerebral vessel stensosis by magnetic resonance angiography, lower rates of vaso-occlusive pain and acute chest syndrome and lower haemoglobin levels. The prevalence of silent infarcts in young children with SCD-SS is similar to that of older children and anaemia and severe vasculopathy may be risk factors.
Kwiatkowski
Janet L
JL
Division of Hematology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. kwiatkowski@email.chop.edu
Zimmerman
Robert A
RA
Pollock
Avrum N
AN
Seto
Wendy
W
Smith-Whitley
Kim
K
Shults
Justine
J
Blackwood-Chirchir
Anne
A
Ohene-Frempong
Kwaku
K
D000755:Anemia, Sickle Cell / Q000150:complications*; D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007223:Infant; D018810:Magnetic Resonance Angiography; D008297:Male; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000209:etiology; D018608:Ultrasonography, Doppler