Project Details

Transcranial doppler flow velocity in iron deficient Nigerian children with Sickle Cell Disease

Shehu Abdullahi, MD, FWACP

Summary

BACKGROUND: Iron deficiency anemia is common in children with sickle cell anemia living in sub-Saharan Africa and is an independent risk factor for pediatric strokes in children with sickle cell anemia. Approximately 11% of the children with sickle cell anemia will have strokes by the 14th birthday, and the prevalence of iron deficiency anemia in Nigerian children with SCA is as high as 50%. We tested two hypotheses: 1) iron deficiency anemia is associated with an increased TCD measurement when compared to children with SCA who are iron-replete, and 2) for children with SCA who are iron deficient; iron supplementation will significantly decrease TCD velocity. METHODS: Cross-sectional prospective cohort study conducted among children with SCA aged 5 to 12 years at Aminu Kano Teaching Hospital, Nigeria. Eligibility included, SCA, TCD value less than 200 cm/sec, and iron-deficient (defined as serum ferritin < 30 µg/L). Complete blood counts, serum ferritin levels, and TCD measurements were assessed in children with SCA and iron-replete groups. Both groups had TCD measurements at baseline and three months later. RESULTS: A total of 24 participants (12%) had iron deficiency anemia) and were consented and assented to receive iron supplementation for 3 months (treatment group); 69 children (34.5%) without IDA were followed up as a comparison group. The mean baseline TCD measurement was 129.1 cm/sec and 127.2 cm/sec for the iron-deficient and comparison groups, respectively, (p=0.730). After three months of iron treatment in the treatment group, there was no statistical difference in change in the TCD measurement 125.3 cm/sec and 121.5 cm/sec, respectively (p=0.478). Conclusion: For children with TCD measurements less than 200 cm/sec, TCD measurements with and without iron deficiency are not statistically different. Further treatment for iron deficiency is not associated with a significant decrease in TCD measurements.