Laboratory markers of thrombosis risk in children with hereditary spherocytosis

Troendle, Sarah; Adix, Leah; Crary, Shelley E.; Buchanan, George R.

doi:10.1002/pbc.21319

Cited by 30 publications

(24 citation statements)

References 36 publications

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“…These blood count measurements in asplenic HS subjects are also higher than normal population means for age and gender (Fig. 1) [13,19]. This finding is interesting in that the Framingham Heart Study has demonstrated that even a small increase in hemoglobin concentration poses an increased risk for vascular complications [20,21].…”

Section: Discussionmentioning

confidence: 84%

“…We have previously shown that children with HS following splenectomy had elevated platelet counts and higher than normal hemoglobin levels, which persisted for many years, and that children with HS prior to splenectomy had hypocholesterolemia [13]. The aim of this current study was to prospectively determine if splenectomy affects selected laboratory markers of cardiovascular risk in individuals with HS in order to better define the relative roles of hemolysis and splenectomy in maintenance of vascular homeostasis.…”

Section: Introductionmentioning

confidence: 98%

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Traditional laboratory measures of cardiovascular risk in hereditary spherocytosis

Crary

Troendle

Ahmad

et al. 2010

Pediatric Blood & Cancer

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Background Individuals who have undergone splenectomy may be at an increased risk of arterial and venous thrombosis. We sought to determine if splenectomy affects surrogate laboratory measures of cardiovascular risk in persons with hereditary spherocytosis (HS). Procedure We conducted a prospective cross-sectional study of 21 children and 36 adults with HS. Fasting blood samples were collected for complete blood count and plasma lipid panel, homocysteine, lipoprotein (a), C-reactive protein, and fibrinogen. The variables were compared between the groups with and without prior splenectomy by Mann–Whitney tests. Results Subjects with prior splenectomy had higher hemoglobin, white blood cell and platelet counts and lower reticulocyte counts and total serum bilirubin concentrations (P < 0.001). Subjects not having had splenectomy had lower than normal levels of total and LDL-cholesterol (LDL-C). Total and LDL-C values were significantly higher, as were fibrinogen and homocysteine concentrations, in the post-splenectomy subjects than in individuals with intact spleen. Conclusion Various lipid levels and other measures of cardiovascular risk are affected by splenectomy in persons with HS. Further investigations are indicated to more clearly define the balance of the potential benefits of hemolysis and anemia versus the deleterious effects of splenectomy in HS.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 98%

Traditional laboratory measures of cardiovascular risk in hereditary spherocytosis

Crary

Troendle

Ahmad

et al. 2010

Pediatric Blood & Cancer

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“…Increased blood viscosity and hypercoagulable state also contribute to the vasculopathy that leads to stroke [2,12]. Possible laboratory biomarkers of thrombosis after splenectomy, in patients with hereditary spherocytosis, include mild polycythemia and elevated platelet counts, C-reactive protein (CRP) and D-dimer levels [10,13,14]. In our study, the platelet counts were significantly increased after splenectomy and remained persistently high throughout the follow-up period.…”

Section: Discussionmentioning

confidence: 68%

Changes in Cerebral Blood Flow in Children with Sickle Cell Disease After Splenectomy

Siddiqui

Soh

2015

Pediatric Hematology and Oncology

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The study assessed changes in cerebral blood flow and need for chronic blood transfusions in sickle cell disease children after splenectomy. A retrospective chart review of 40 children splenectomized between 1999 and 2014 was performed. The mean time-average maximum velocity before splenectomy was 129 cm/sec; which increased to 157 cm/sec and then decreased to 137 cm/sec, 2 and 5 years postsplenectomy, respectively. There was a persistent and statistically significant elevation in platelet count noted after splenectomy. The mean cerebral blood flow velocity seemed to increase transiently after splenectomy. Close monitoring and screening for stroke risk should be continued postsplenectomy.

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“…There may be a rebound effect in a few patients, with the hemoglobin exceeding the normal range. In a study by Troendle et al from Texas, 9 (30%) of 30 patients had a post‐splenectomy hemoglobin between 90 and 97th centile, and 5 (17%) had a level exceeding 97th centile. The Framingham heart study demonstrated a twofold rise in the incidence of stroke in persons with a higher hemoglobin concentration, probably related to higher blood viscosity .…”

Section: Discussionmentioning

confidence: 96%

Risk factors for thromboembolism and pulmonary artery hypertension following splenectomy in children with hereditary spherocytosis

Das¹,

Bansal²,

Ahluwalia

et al. 2013

Pediatric Blood & Cancer

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There was no evidence of PAH, dyslipidemia, elevation of fibrinogen or a reduction in anti-coagulant proteins, at a median follow-up duration of 4.5 years following splenectomy in children with HS. However, elevated CRP level (42%), persistent thrombocytosis (73%) and elevated D-dimer levels (23%) were observed. These have been recognized as risk factors for cerebrovascular and coronary heart disease.

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Laboratory markers of thrombosis risk in children with hereditary spherocytosis

Cited by 30 publications

References 36 publications

Traditional laboratory measures of cardiovascular risk in hereditary spherocytosis

Traditional laboratory measures of cardiovascular risk in hereditary spherocytosis

Changes in Cerebral Blood Flow in Children with Sickle Cell Disease After Splenectomy

Risk factors for thromboembolism and pulmonary artery hypertension following splenectomy in children with hereditary spherocytosis

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