Relationship between Haematological Parameters and Cerebral Blood Flow Velocities in Sickle Cell Anaemia Children Seen At A Tertiary Hospital In Imo State

Dr EZEUKO Lilian Chinasa; Dr ODUNVBUN Magdalene E; Dr IKEJIAKU Udochikwuka Patience; Dr IKE Innocent Ifeanyi; Dr ANTHONY-EWEPUTANNA  Sylvia Adaku Adaku; Dr. KAWA Alaoma Chibueze; Dr. EZERIOHA Ogechi Patience; Dr. EZEUKO Vitalis Chukwuma

doi:10.18535/ijsrm/v13i02.mp07

Abstract

Background: Sickle Cell Anaemia (SCA) is a chronic haemolytic state associated with recurrent blood transfusions, infections and its attendant complications. The study compared the relationship between cerebral artery blood flow velocities(CBFV), steady state packed cell volume and white blood cell counts of male and female SCA children aged 2-16 years seen at Federal Teaching Hospital Owerri, Imo state.

Methods: Transcranial Doppler ultrasound, haematology test(Packed cell volume and white blood cell count) were done for SCA children that attended the sickle cell specialist clinic of the hospital between April and September 2023.

Results: A total of 102 subjects were screened within the study period. The mean packed cell volume was statistically significantly lower in males than females (p= 0.010). There was no difference in the mean white cell count in both genders. Abnormal CBFV was found in17.6% of subjects

Conclusion: The prevalence of abnormal cerebral blood flow velocity in SCA children is 17.6%. Identification of subjects at risk for a CVA helped in primary prevention by prompt therapy institution.

Keywords:Sickle cell anaemia, cerebral artery blood flow velocities packed cell volume, white blood cell count.

Keywords

Sickle cell anaemiacerebral artery blood flow velocities packed cell

References

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Araba AB. A survey of haematological variable in 600 healthy Nigerians. Niger MedJ.1976;6:49-53.Google Scholar ↗
Adekile AD. Anthropology of the beta s gene-flow from West Africa to North Africa, Mediterranean and Southern Europe. Haemoglobin.1992;16(1-2):105-21.Google Scholar ↗
Bunn HF. Pathogenesis and treatment of sickle cell disease. N Engl J Med 1997; 337(11): 762-9.Google Scholar ↗
Quinn CT, Lee NJ, Shull EP, Ahmed N, Rogers ZR. Prediction of adverse outcomes in children with sickle cell anaemia: a study of the Dallas Newborn Cohort.Blood.2008;111(2):544-8Google Scholar ↗
Lim SH, Fast L, Morris A. sickle cell vaso-occlusive crisis: it’s a gut feeling.JTransl Med.2016; 14:334-8Google Scholar ↗
Michael RD, Kirkham FJ. Central nervous system complications and management in sickle cell disease. Blood 2016;127(7):829-38Google Scholar ↗
Fatunde OJ, Adamson FG, Ogunseyinde O, Sodeinde O, Familusi JB. Stroke in Nigerian children with sickle cell disease. Afr J Med Sci.2005;34(2):157-60Google Scholar ↗
Lagunju IA, Brown BJ. Adverse neurological outcomes in Nigerian children with sickle cell disease. Int J Hematol.2012; 96(6):710-8Google Scholar ↗
Gill FM, Sleeper LA, Weiner SJ, Brown AK, Bellevue R, Groover R, et al. Clinical events in the first decade in a cohort of infants with sickle cell disease. Cooperative Study of Sickle cell disease. Blood.1995;86(2):776-83.Google Scholar ↗
Ohene- Frempong K, Weiner SJ, Sleeper LA, Miller ST, Embury S, Moohr JW, Wethers DL. Cerebrovascular accidents in sickle cell disease: rates and risk factors.Blood. 1998; 91(1):288-94.Google Scholar ↗
Balkaran B, Char G, Morris J, Thomas PW,Serjeant BE, Serjeant GR. Stroke in a cohort of patients with homozygous sickle cell disease. J Pediatr 1992;120(3):360-6.Google Scholar ↗
Adekunle OM, Adeola BA, Ijeoma N, Njokanma FO. Pattern of cerebral blood flow velocity using transcranial Doppler in children with sickle cell disorder in Lagos state Nigeria. Mediterr J Hematol Infect Dis. 2017; 9(1):e2017050.Google Scholar ↗
Langunju IA, Sodeinde O, Brown BJ, Akinbami F, Adedokun B. Transcranial Doppler ultrasonography in children with Sickle Cell Anaemia: Clinical and laboratory correlates for elevated blood flow velocities. J ClinUltrasond. 2014;42 (2)89-95Google Scholar ↗
Ismail A, Yusuf AB, Kuliya-Gwarzo A, Ahmed G, Abubakar SA. Correlating transcranial arterial doppler velocities with haematologic parameters and haematologic indices of Nigerian children with sickle cell anaemia. Ultrasound. 2019;27(2):101-10.Google Scholar ↗
Rankine-Mullings AE, Morrison-Levy N, Soares D, Aldred K, King L, Ali S, et al. Transcranial Doppler velocity among Jamaican children with sickle cell anaemia: Determining the significance of haematological values and nutrition. Br J Haematol. 2018;181(2):242-51.Google Scholar ↗
Ahmed PA, Otuneye OT. Stroke at National Hospital Abuja. Presented at the 33rd Annual and General Scientific meeting of Paediatric Association of Nigeria. January 2002.Google Scholar ↗
Kehinde OM, Edamisan OT, Mustapha AD. Neurological complications of Sickle Cell Anaemia in Nigeria Africans- a case control study.JNatl Med Assoc.2008;100(4):394-400.Google Scholar ↗
Oniyangi O, Akano AO, Wakama TT, Oyesakin AB. Transcranial Doppler studies for the primary prevention of strokes among children with sickle cell disease in Nigeria- a single tertiary centre experience. Research 2014; 1:825.Google Scholar ↗

[refR-1] Diallo D, Tchernia G. Sickle Cell Disease in Africa. CurrOpinHaematol. 2002;9(2):111-6.Google Scholar ↗

[refR-2] Araba AB. A survey of haematological variable in 600 healthy Nigerians. Niger MedJ.1976;6:49-53.Google Scholar ↗

[refR-3] Adekile AD. Anthropology of the beta s gene-flow from West Africa to North Africa, Mediterranean and Southern Europe. Haemoglobin.1992;16(1-2):105-21.Google Scholar ↗

[refR-4] Bunn HF. Pathogenesis and treatment of sickle cell disease. N Engl J Med 1997; 337(11): 762-9.Google Scholar ↗

[refR-5] Quinn CT, Lee NJ, Shull EP, Ahmed N, Rogers ZR. Prediction of adverse outcomes in children with sickle cell anaemia: a study of the Dallas Newborn Cohort.Blood.2008;111(2):544-8Google Scholar ↗

[refR-6] Lim SH, Fast L, Morris A. sickle cell vaso-occlusive crisis: it’s a gut feeling.JTransl Med.2016; 14:334-8Google Scholar ↗

[refR-7] Michael RD, Kirkham FJ. Central nervous system complications and management in sickle cell disease. Blood 2016;127(7):829-38Google Scholar ↗

[refR-8] Fatunde OJ, Adamson FG, Ogunseyinde O, Sodeinde O, Familusi JB. Stroke in Nigerian children with sickle cell disease. Afr J Med Sci.2005;34(2):157-60Google Scholar ↗

[refR-9] Lagunju IA, Brown BJ. Adverse neurological outcomes in Nigerian children with sickle cell disease. Int J Hematol.2012; 96(6):710-8Google Scholar ↗

[refR-10] Gill FM, Sleeper LA, Weiner SJ, Brown AK, Bellevue R, Groover R, et al. Clinical events in the first decade in a cohort of infants with sickle cell disease. Cooperative Study of Sickle cell disease. Blood.1995;86(2):776-83.Google Scholar ↗

[refR-11] Ohene- Frempong K, Weiner SJ, Sleeper LA, Miller ST, Embury S, Moohr JW, Wethers DL. Cerebrovascular accidents in sickle cell disease: rates and risk factors.Blood. 1998; 91(1):288-94.Google Scholar ↗

[refR-12] Balkaran B, Char G, Morris J, Thomas PW,Serjeant BE, Serjeant GR. Stroke in a cohort of patients with homozygous sickle cell disease. J Pediatr 1992;120(3):360-6.Google Scholar ↗

[refR-13] Adekunle OM, Adeola BA, Ijeoma N, Njokanma FO. Pattern of cerebral blood flow velocity using transcranial Doppler in children with sickle cell disorder in Lagos state Nigeria. Mediterr J Hematol Infect Dis. 2017; 9(1):e2017050.Google Scholar ↗

[refR-14] Langunju IA, Sodeinde O, Brown BJ, Akinbami F, Adedokun B. Transcranial Doppler ultrasonography in children with Sickle Cell Anaemia: Clinical and laboratory correlates for elevated blood flow velocities. J ClinUltrasond. 2014;42 (2)89-95Google Scholar ↗

[refR-15] Ismail A, Yusuf AB, Kuliya-Gwarzo A, Ahmed G, Abubakar SA. Correlating transcranial arterial doppler velocities with haematologic parameters and haematologic indices of Nigerian children with sickle cell anaemia. Ultrasound. 2019;27(2):101-10.Google Scholar ↗

[refR-16] Rankine-Mullings AE, Morrison-Levy N, Soares D, Aldred K, King L, Ali S, et al. Transcranial Doppler velocity among Jamaican children with sickle cell anaemia: Determining the significance of haematological values and nutrition. Br J Haematol. 2018;181(2):242-51.Google Scholar ↗

[refR-17] Ahmed PA, Otuneye OT. Stroke at National Hospital Abuja. Presented at the 33rd Annual and General Scientific meeting of Paediatric Association of Nigeria. January 2002.Google Scholar ↗

[refR-18] Kehinde OM, Edamisan OT, Mustapha AD. Neurological complications of Sickle Cell Anaemia in Nigeria Africans- a case control study.JNatl Med Assoc.2008;100(4):394-400.Google Scholar ↗

[refR-19] Oniyangi O, Akano AO, Wakama TT, Oyesakin AB. Transcranial Doppler studies for the primary prevention of strokes among children with sickle cell disease in Nigeria- a single tertiary centre experience. Research 2014; 1:825.Google Scholar ↗