Silent cerebral infarct in sickle cell anemia patients of southern Turkey

Authors: EZGİ NAFİLE SAYMAN, GÖKSEL LEBLEBİSATAN, ŞERİFE LEBLEBİSATAN, YUNUS KENAN BIÇAKCI, YURDANUR KILINÇ, ADNAN BARUTÇU

Abstract: Background/aim: Silent cerebral infarct (SCI) is an ischemic lesion seen before clinical signs of brain infarct and ischemic changes in brain tissue. This study aimed to detect SCI with noninvasive methods and to determine related risk factors in patients with sickle cell anemia (SCA). Materials and methods: Fifty-four SCA patients who had no history of cerebral infarct and whose neurological examinations were normal were included in this study. Brain magnetic resonance imaging (MRI) and diffusion MRI were taken and the acquired data was compared statistically. Results: SCI was detected in 11.1% (6/54) of the patients. No statistical differences in age, sex, physical examination findings, or treatments were detected between the 2 groups (with and without SCI). When examined in terms of HbS, the median (min-max) value in SCI-positive patients was 85.4 (80.5-92.1); the median value was 77.2 (49.0-96.7) in SCI-negative patients. The HbS values of the SCI group were statistically significantly higher than those of the group without SCI (P = 0.014). Patients with the HbSS or HbSß0 genotypes had a significantly higher prevalence of SCI when compared with other sickle cell syndromes (P = 0.038). Conclusion: SCI is not uncommon among SCA patients in Turkey. The presence of homozygote HbSS/Sß0 genotype, high MCV, and HbS are risk factors for SCI.

Keywords: Sickle cell anemia, silent cerebral infarct, stroke, magnetic resonance imaging, children

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