title: Association between endothelial dysfunction and otoneurological symptoms in children with sickle cell disease.
abstract: OBJECTIVE
  To evaluate the association between endothelial dysfunction and otoneurological symptoms and vaso-occlusive phenomena in children with sickle cell disease (SCD).
  
  
  METHODS
  Cross-sectional study with 54 children, aged between 6 and19 years of age, of whom 28 had genotype SS and 26 apparently healthy (AA genotype) whose parents or guardians, or the children themselves, filled out a questionnaire designed to assess their otoneurological symptoms. All the individuals were submitted assessment of endothelial function by flow-mediated dilation (FMD) percentage with reactive hyperemia of brachial artery Doppler.
  
  
  RESULTS
  Otoneurological symptoms (tinnitus and/or vertigo) predominated in the SCD group (46.4 vs. 15.4%; p = 0.006). A negative correlation was observed between FMD percentage and time of evolution of vertigo SCD (r = -0.432; p = 0.022) and the linear regression analysis demonstrated that for every reduction in FMD percentage there was an increase in time of evolution of vertigo of 1.79 months (β = -1.79; p = 0.022). The positive correlation between episodes of painful crisis and time of evolution of vertigo (r = 0.3; p = 0.04).
  
  
  CONCLUSIONS
  The presence of vascular endothelial damage in the labyrinthine artery in patients with SCD is capable of compromising the semicircular canals, shown by clinical expression of otoneurological symptoms, such as vertigo. In the present study, an association was observed between endothelial dysfunction with otoneurological symptoms and otoneurological symptoms and vaso-occlusive phenomena in SCD.
authors.affiliation: a Bahiana School of Medicine and Public Health , Salvador , Brazil.|b Department of Life Science , State University of Bahia , Salvador , Brazil.
authors.forename: Mara Renata
authors.initials: MR
authors.lastname: Rissatto-Lago
authors.affiliation: a Bahiana School of Medicine and Public Health , Salvador , Brazil.
authors.forename: Cristina
authors.initials: C
authors.lastname: Salles
authors.affiliation: a Bahiana School of Medicine and Public Health , Salvador , Brazil.
authors.forename: Fernando Gesteira
authors.initials: FG
authors.lastname: Campos de Pinho
authors.affiliation: c Federal University of Bahia, University Hospital Professor Edgar Santos-Pediatric Hematology , Salvador , Brazil.
authors.forename: Isa
authors.initials: I
authors.lastname: Menezes Lyra
authors.affiliation: d Department of Pediatrics , School of Medicine of Bahia, Federal University of Bahia , Salvador , Brazil.
authors.forename: Regina
authors.initials: R
authors.lastname: Terse-Ramos
authors.affiliation: a Bahiana School of Medicine and Public Health , Salvador , Brazil.|d Department of Pediatrics , School of Medicine of Bahia, Federal University of Bahia , Salvador , Brazil.
authors.forename: Rozana
authors.initials: R
authors.lastname: Teixeira
authors.affiliation: a Bahiana School of Medicine and Public Health , Salvador , Brazil.
authors.forename: Ana Marice
authors.initials: AM
authors.lastname: Ladeia
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia; D008297:Male; D014012:Tinnitus / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D014717:Vertigo / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*
keywords: Sickle cell disease; tinnitus; vascular endothelium; vertigo