Brain injury pathophysiology study by a multimodal approach in children with sickle cell anemia with no intra or extra cranial arteriopathy - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Haematologica Année : 2020

Brain injury pathophysiology study by a multimodal approach in children with sickle cell anemia with no intra or extra cranial arteriopathy

Valentine Brousse
  • Fonction : Auteur
Corinne Pondarre
  • Fonction : Auteur
Manoelle Kossorotoff
  • Fonction : Auteur
Cecile Arnaud
  • Fonction : Auteur
Annie Kamdem
  • Fonction : Auteur
Mariane De Montalembert
  • Fonction : Auteur
Benedicte Boutonnat-Faucher
  • Fonction : Auteur
Hélène Bourdeau
  • Fonction : Auteur
Key Ne Charlot
  • Fonction : Auteur
Sebastien Bertil
  • Fonction : Auteur
Lydie da Costa
Philippe Connes
David Grévent
  • Fonction : Auteur
Suzanne Verlhac
  • Fonction : Auteur

Résumé

Despite its high prevalence in children with sickle cell anemia (SCA), the pathophysiology of silent cerebral infarcts (SCIs) remains elusive. The main objective of this study was to explore the respective roles of major determinants of brain perfusion in SCA children with no past or current history of intracranial or extracranial vasculopathy. We used a multimodal approach based notably on perfusion imaging Arterial spin labelling (ASL) MRI and Near Infra-Red Spectroscopy (NIRS), as well as biomarkers reflecting blood rheology and endothelial activation. Out of 59 SCA patients (mean age 11.4} 3.9 yrs), 8 (13%) had a total of 12 SCIs. Children with SCIs had a distinctive profile characterized by decreased blood pressure, impaired blood rheology, increased P-selectin levels, and marked anemia. Although ASL perfusion and oximetry values did not differ between groups, comparison of biological and clinical parameters according to the level of perfusion categorized in terciles showed an independent association between high perfusion and increased sP-selectin, decreased RBC deformability, low HbF level, increased blood viscosity and no alpha-thalassemia deletion. NIRS measurements did not yield additional novel results. Altogether, these findings argue for early MRI detection of SCIs in children with no identified vasculopathy and suggest a potential role for ASL as an additional screening tool. Early treatment targeting hemolysis, anemia and endothelial dysfunction should reduce the risk of this under diagnosed and serious complication.

Dates et versions

hal-03601729 , version 1 (08-03-2022)

Identifiants

Citer

Keyne Charlot, Valentine Brousse, Corinne Pondarre, Manoelle Kossorotoff, Cecile Arnaud, et al.. Brain injury pathophysiology study by a multimodal approach in children with sickle cell anemia with no intra or extra cranial arteriopathy. Haematologica, 2020, ⟨10.3324/haematol.2020.278226⟩. ⟨hal-03601729⟩
14 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Mastodon Facebook X LinkedIn More