title: Silent infarcts in young children with sickle cell disease.
abstract: 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.
authors.affiliation: Division of Hematology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. kwiatkowski@email.chop.edu
authors.forename: Janet L
authors.initials: JL
authors.lastname: Kwiatkowski
authors.forename: Robert A
authors.initials: RA
authors.lastname: Zimmerman
authors.forename: Avrum N
authors.initials: AN
authors.lastname: Pollock
authors.forename: Wendy
authors.initials: W
authors.lastname: Seto
authors.forename: Kim
authors.initials: K
authors.lastname: Smith-Whitley
authors.forename: Justine
authors.initials: J
authors.lastname: Shults
authors.forename: Anne
authors.initials: A
authors.lastname: Blackwood-Chirchir
authors.forename: Kwaku
authors.initials: K
authors.lastname: Ohene-Frempong
mesh_terms: 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