Dépistage de la vasculopathie cérébrale drépanocytaire par doppler transcrânien au Mali

Dorie, A.; Guindo, Aldiouma; Saro, Y.S.; Touré, Boubacari Ali; Fané, Baba; Dembélé, A; Diallo, Dapa A.

doi:10.1016/j.arcped.2014.12.005

Cited by 10 publications

(5 citation statements)

References 24 publications

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“…5 A recent observational study including 144 HbSC and 27 HbS/β + out of 572 total participants from a Mali population, reported a low frequency (1.5%) of HbSC patients having conditional velocities, and no patients with abnormal TCD reading, as compared to 17.3% conditional HbSS and 8.1% high risk, suggesting that the TCD profile is different in the two genotypes. 36 Whether screening HbSC patients in childhood is clinically useful is uncertain. 15…”

Section: Resultsmentioning

confidence: 99%

Transcranial Doppler screening for stroke risk in children with sickle cell disease: a systematic review

Mazzucco

Diomedi

Qureshi³

et al. 2017

International Journal of Stroke

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Background Sickle cell disease (SCD) is one of the most common causes of stroke in children worldwide. Based on the results of the Stroke Prevention Trial in Sickle Cell Anemia (STOP), annual transcranial Doppler ultrasound (TCD) screening for affected children is standard practice. However, the need for TCD surveillance programs could override the accuracy of the screening, affecting the correct stratification of stroke risk and subsequent clinical management of the target population. Aims To shed light on this issue, a systematic review of the literature on TCD screening for children and adolescents with SCD was carried out (CRD42016050549), according to a list of clinically relevant questions, with a particular focus on screening practices in European countries. Quality of the evidence was rated using the grading of recommendations assessment, development and evaluation. Summary of review Thirty-three studies published in English or French were included (5 randomized controlled trials, 8 experimental non-randomized, and 20 observational studies). The quality of the retrieved evidence ranged between low and high, but was rated as moderate or high most of the times. TCD is effective as a screening tool for the primary prevention of stroke in SCD children. There is no high-quality evidence on the effectiveness of alternative screening methods, such as imaging-TCD with or without angle correction or magnetic resonance angiography. No evidence was found on effectiveness of the screening on children on hydroxyurea and with genotypes other than HbSS and HbS/β0. No European data were found on screening rates or adherence of screening practices to the STOP protocol. Conclusions High-quality studies on alternative screening methods that are currently used in real-world practice, and on screening applicability to specific subgroups of patients are urgently needed. Considering the low awareness of the disease in European countries and the lack of data on screening practices and adherence, clinicians need up-to-date guidelines for more uniform and evidence-based surveillance of children with SCD.

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Section: Resultsmentioning

confidence: 99%

Transcranial Doppler screening for stroke risk in children with sickle cell disease: a systematic review

Mazzucco

Diomedi

Qureshi³

et al. 2017

International Journal of Stroke

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“…Interestingly, BA flow characteristics showed the correlations similar to MCA and intracranial ICA. [16] About 11% of our study participants showed TAMMV of more than 200 cm/s. This proportion in an unselected Abbreviations: BMI = body mass index; HbSS = Hemoglobin SS; SCD = sickle cell disease; SD = standard deviation.…”

Section: Discussionmentioning

confidence: 72%

“…Interestingly, BA flow characteristics showed the correlations similar to MCA and intracranial ICA. [16]…”

Section: Discussionmentioning

confidence: 99%

“…Anemia and the resultant hypoxia in SCD are believed to cause chronic cerebral vasodilation and elevated cerebral blood flow and velocities. [11,12,16] Accordingly, blood Hb and HbS levels may be considered as indirect measures of the severity of anemia and cerebral hypoxia. However, contrary to the existing literature, we did not find an association between HbS and TAMMV.…”

Section: Discussionmentioning

confidence: 99%

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Cerebral hemodynamics in children with sickle cell disease in India: An observational cohort study

et al. 2022

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India has the second highest number of cases of sickle cell disease (SCD) and affects the most socioeconomically disadvantaged communities living in a horizontal belt from Gujarat to Odisha state. Despite high prevalence, information about cerebral hemodynamics among children with SCD in India remains scarcely described.We performed transcranial Doppler (TCD) to assess cerebral hemodynamics among Indian children with SCD and evaluated their association with clinical and hematological parameters.Children aged 3-18years, diagnosed with SCD living in Raipur in Chhattisgarh and Ahmedabad in Gujarat state were recruited. TCD was performed to obtain flow velocities from middle cerebral (MCA), intracranial internal carotid (ICA) and basilar artery. Associations were evaluated between timed-average-mean-maximum velocities (TAMMV) and various clinical and hematological parameters.Our prospective study included 62 consecutive children with known SCD. Mean ± SD age of the study population was 9.8 ± 3.9 years and 31 (50%) were male. Mean ± SD hemoglobin was 8.64 ± 1.34 Gm/dL while the mean HbSS ± SD was 70.25 ± 15.27%. While 6 (9.6%) children had suffered from stroke during previous 2 years, 7 (11%) demonstrated abnormal TAMMV. Higher HbSS level along with history of iron chelation therapy, blood transfusion and/or stroke showed a trend towards having higher TAMMV.Stroke and cerebral hemodynamic alterations are common among Indian children with SCD. Larger studies with detailed neuroimaging and genetic evaluations are needed for better understanding, characterization, risk stratification as well as optimization of the timing of blood transfusion to reduce physical disabilities among Indian children with SCD.

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“…5 A recent observational study including 144 HbSC and 27 HbS/ß + out of 572 total participants from a Mali population, reported a low frequency (1.5%) of HbSC patients having conditional velocities, and no patients with abnormal TCD reading, as compared to 17.3% conditional HbSS and 8.1% high risk, suggesting that the TCD profile is different in the two genotypes. 36 Whether screening HbSC patients in childhood is clinically useful is uncertain. 15…”

Section: Whom Does Tcd Screening Apply To?mentioning

confidence: 99%

Transcranial Doppler Screening for Stroke Risk in Children With Sickle Cell Disease: A Systematic Review.

Mazzucco¹

2017

Preprint

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Background: Sickle Cell Disease (SCD) is one of the most common causes of stroke in children worldwide. Based on the results of the Stroke Prevention Trial in Sickle Cell Anaemia (STOP), annual Transcranial Doppler Ultrasound (TCD) screening for affected children is standard practice. However, the need for TCD surveillance programmes could override the accuracy of the screening, affecting the correct stratification of stroke risk and subsequent clinical management of the target population. Aims: To shed light on this issue, a systematic review of the literature on TCD screening for children and adolescents with SCD was carried out (CRD42016050549), according to a list of clinically relevant questions, with a particular focus on screening practices in European countries. Quality of the evidence was rated using GRADE. Summary of review: Thirty-three studies published in English or French were included (5 randomised controlled trials, 8 experimental non-randomised and 20 observational studies). The quality of the retrieved evidence ranged between low and high, but was rated as moderate or high most of the times. TCD is effective as a screening tool for primary prevention of stroke in SCD children. There is no high quality evidence on the effectiveness of alternative screening methods, such as imaging-TCD (TCDi) with or without angle correction or magnetic resonance angiography (MRA). No evidence was found on effectiveness of the screening on children on hydroxyurea and with genotypes other than HbSS and HbS/β0. No European data were found on screening rates or adherence of screening practices to the STOP protocol. Conclusions: High quality studies on alternative screening methods that are currently used in real-world practice, and on screening applicability to specific subgroups of patients are urgently needed. Considering the low awareness of the disease in European countries and the lack of data on screening practices and adherence, clinicians need up-to-date guidelines for more uniform and evidence-based surveillance of children with SCD.

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Dépistage de la vasculopathie cérébrale drépanocytaire par doppler transcrânien au Mali

Cited by 10 publications

References 24 publications

Transcranial Doppler screening for stroke risk in children with sickle cell disease: a systematic review

Transcranial Doppler screening for stroke risk in children with sickle cell disease: a systematic review

Cerebral hemodynamics in children with sickle cell disease in India: An observational cohort study

Transcranial Doppler Screening for Stroke Risk in Children With Sickle Cell Disease: A Systematic Review.

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