title: Brazilian Guidelines for transcranial doppler in children and adolescents with sickle cell disease.
abstract: BACKGROUND
  Sickle cell disease is the most common monogenic hereditary disease in Brazil. Although strokes are one of the main causes of morbidity and mortality in these patients, the use of transcranial Doppler to identify children at risk is not universally used.
  
  
  OBJECTIVE
  To develop Brazilian guidelines for the use of transcranial Doppler in sickle cell disease children and adolescents, so that related health policies can be expanded, and thus contribute to reduce morbidity and mortality.
  
  
  METHODS
  The guidelines were formulated in a consensus meeting of experts in transcranial Doppler and sickle cell disease. The issues discussed were previously formulated and scientific articles in databases (MEDLINE, SciELO and Cochrane) were carefully analyzed. The consensus for each question was obtained by a vote of experts on the specific theme.
  
  
  RESULTS
  Recommendations were made, including indications for the use of transcranial Doppler according to the sickle cell disease genotype and patients age; the necessary conditions to perform the exam and its periodicity depending on exam results; the criteria for the indication of blood transfusions and iron chelation therapy; the indication of hydroxyurea; and the therapeutic approach in cases of conditional transcranial Doppler.
  
  
  CONCLUSIONS
  The Brazilian guidelines on the use of transcranial doppler in sickle cell disease patients may reduce the risk of strokes, and thus reduce the morbidity and mortality and improve the quality of life of sickle cell disease patients.
authors.affiliation: Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO), Rio de Janeiro (RJ), Brazil.
authors.forename: Clarisse Lopes de Castro
authors.initials: CL
authors.lastname: Lobo
authors.forename: Rodolfo Delfini
authors.initials: RD
authors.lastname: Cançado
authors.forename: Ana Claudia Celestino Bezerra
authors.initials: AC
authors.lastname: Leite
authors.forename: Ana Claudia Mendonça
authors.initials: AC
authors.lastname: Dos Anjos
authors.forename: Ana Cristina Silva
authors.initials: AC
authors.lastname: Pinto
authors.forename: Andre Palma da Cunha
authors.initials: AP
authors.lastname: Matta
authors.forename: Célia Maria
authors.initials: CM
authors.lastname: Silva
authors.forename: Gisele Sampaio
authors.initials: GS
authors.lastname: Silva
authors.forename: João Ricardo
authors.initials: JR
authors.lastname: Friedrisch
authors.forename: Josefina Aparecida Pellegrini
authors.initials: JA
authors.lastname: Braga
authors.forename: Marcos Christiano
authors.initials: MC
authors.lastname: Lange
authors.forename: Maria Stella
authors.initials: MS
authors.lastname: Figueiredo
authors.forename: Marília Álvares
authors.initials: MÁ
authors.lastname: Rugani
authors.forename: Orlando
authors.initials: O
authors.lastname: Veloso
authors.forename: Patrícia Gomes
authors.initials: PG
authors.lastname: Moura
authors.forename: Paulo Ivo
authors.initials: PI
authors.lastname: Cortez
authors.forename: Robert
authors.initials: R
authors.lastname: Adams
authors.forename: Sandra Fátima Menosi
authors.initials: SF
authors.lastname: Gualandro
authors.forename: Shirley Lopes
authors.initials: SL
authors.lastname: de Castilho
authors.forename: Ursula
authors.initials: U
authors.lastname: Thomé
authors.forename: Viviane Flumignan
authors.initials: VF
authors.lastname: Zetola
keywords: Adolescent; Anemia, sickle cell/diagnosis; Anemia, sickle cell/therapy; Child; Guideline; Hemoglobin, sickle; Stroke/prevention & control; Ultrasonography, doppler, transcranial/methods