Conflict of interest: Nothing to declare.
Stroke with intracranial stenosis is associated with increased platelet activation in sickle cell anemia†
Article first published online: 18 MAR 2013
Copyright © 2013 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 60, Issue 7, pages 1192–1197, July 2013
How to Cite
Majumdar, S., Webb, S., Norcross, E., Mannam, V., Ahmad, N., Lirette, S. and Iyer, R. (2013), Stroke with intracranial stenosis is associated with increased platelet activation in sickle cell anemia. Pediatr. Blood Cancer, 60: 1192–1197. doi: 10.1002/pbc.24473
- Issue published online: 22 MAY 2013
- Article first published online: 18 MAR 2013
- Manuscript Accepted: 17 DEC 2012
- Manuscript Received: 1 AUG 2012
- University of Mississippi Medical Center Intramural. Grant Number: 68599340412
- sickle cell anemia;
Overt stroke in sickle cell anemia (SCA) is associated with intracranial stenosis and thrombus formation. Platelet activation is critical for thrombus formation.
Platelet activation studies were performed in 50 subjects: 18 SCA patients with history of stroke or abnormal transcranial Doppler (TCD) and intracranial stenosis seen by magnetic resonance angiogram (MRA), 7 SCA patients with history of stroke or abnormal TCD but no intracranial stenosis, 13 SCA patients with no history of stroke or abnormal TCD, and 12 healthy African-Americans.
Of the 18 patients with intracranial stenosis, 11 (61%) had evidence of the moyo-moya phenomenon on MRA. SCA children with intracranial stenosis had a significantly greater total white cell count compared to both healthy African-American controls and SCA patients in the steady-state (P < 0.001). In addition, SCA patients with history of stroke or abnormal TCD had a significantly higher platelet count compared to healthy African-American controls (P < 0.002). The percentage of platelet surface P-selectin expression was significantly greater in patients with intracranial stenosis compared to the other groups (P < 0.05), particularly in individuals that did not have the moya-moya phenomenon seen on MRA.
Stroke with intracranial stenosis is associated with increased platelet activation in sickle cell anemia, and further investigation is needed on the role of anti-platelet agents in this high-risk population. Pediatr Blood Cancer 2013; 60: 1192–1197. © 2013 Wiley Periodicals, Inc.