title: Abnormal transcranial Döppler ultrasonography in children with sickle cell disease.
abstract: BACKGROUND
  Stroke is a potentially fatal complication of sickle cell disease in children between 2-16 years and transcranial Döppler has been recommended as a screening method in these cases.
  
  
  OBJECTIVE
  The main goal of this study was to correlate transcranial Döppler results to complications related to stroke in sickle cell disease and baseline characteristics of the population.
  
  
  METHODS
  This was an observational study of children and adolescents with ages between 2-16 years with sickle cell disease who were followed in three centers.
  
  
  RESULTS
  From January 2008 to July 2009, 902 patients were enrolled in this study. The median age was 6.5 years (range: 1.8-15.8), 52.3% were male, 74.4% had hemoglobin SS; 221 (28.6%) had at least one complication associated with sickle cell disease. A total of 773 patients performed transcranial Döppler; in 91.2% this was a method of screening. Conditional or abnormal transcranial Döppler results were more common in patients with sickle cell disease complications versus those without complications (ODDS ratio = 3.18; 95% Confidence interval = 1.92-5.27). There was a significant difference in the frequency of conditional or abnormal transcranial Döppler results in patients with abnormal laboratory results compared to those without abnormalities (OR=4.03); 95% confidence interval = 2.30-7.06.
  
  
  CONCLUSIONS
  Conditional or abnormal transcranial Döppler results were significantly more frequent in patients with complications of sickle cell disease confirming the increased risk of stroke in this subgroup of patients. This observation reinforces the recommendation of transcranial Döppler as a screening test for all patients with sickle cell disease with ages between 2 and 16 years.
authors.affiliation: Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti - Hemorio, Rio de Janeiro, RJ, Brazil ;  Instituto de Pesquisa Clínica Evandro Chagas - IPEC, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Ana Claudia Celestino Bezerra
authors.initials: AC
authors.lastname: Leite
authors.forename: Raquel Vasconcellos Carvalhaes
authors.initials: RV
authors.lastname: de Oliveira
authors.forename: Patrícia Gomes
authors.initials: PG
authors.lastname: de Moura
authors.forename: Célia Maria
authors.initials: CM
authors.lastname: Silva
authors.forename: Clarisse
authors.initials: C
authors.lastname: Lobo