メタボリックシンドロームジャーナル

Stroke in Severity of Sickle Cell Diseases

Abstract

Mehmet Rami Helvaci, Ramazan Davran, Akin Aydogan, Seckin Akkucuk, Mustafa Ugu, and Cem Oruc

Background: Sickle cell diseases (SCDs) are chronic inflammatory process on capillary level. We tried to understand whether or not there are some positive correlations between stroke and severity of SCDs.
Methods: All patients with SCDs were taken into the study.
Results: The study included 343 patients (169 females and 174 males). There were 30 cases (8.7%) with stroke. The mean ages were similar in both groups (32.5 versus 29.1 years in the stroke group and other, respectively, p>0.05). The female ratios were similar in both groups, too (43.3% versus 49.8%, respectively, p>0.05). Prevalences of associated thalassemia minors were also similar in them (73.3% versus 65.1%, respectively, p>0.05). Smoking was higher among the stroke cases (26.6% versus 13.0%, p<0.05). Mean white blood cell count, hematocrit value, and mean platelet count of the peripheric blood were similar in both groups (p>0.05 for all). On the other hand, although the painful crises per year, tonsilectomy, priapism, ileus, pulmonary hypertension, chronic obstructive pulmonary disease, coronary heart disease, chronic renal disease, rheumatic heart disease, avascular necrosis of bones, cirrhosis, and mortality were all higher in the stroke group, the differences were only significant for digital clubbing, leg ulcers, and acute chest syndrome (p<0.05 for all), probably due to the small sample size of the stroke group.
Conclusion: SCDs are chronic destructive process on capillaries iniatiating at birth, and terminate with early organ failures in life. Probably stroke is one of the terminal consequences of the inflammatory process that may indicate shortened survival in such cases.