Résumé
BACKGROUND: Sickle cell disease is the most common monogenic hereditary disease in Brazil. Although strokes are one of the main causes of morbidity and mortality in these patients, the use of transcranial Doppler to identify children at risk is not universally used. OBJECTIVE: To develop Brazilian guidelines for the use of transcranial Doppler in sickle cell disease children and adolescents, so that related health policies can be expanded, and thus contribute to reduce morbidity and mortality. METHODS: The guidelines were formulated in a consensus meeting of experts in transcranial Doppler and sickle cell disease. The issues discussed were previously formulated and scientific articles in databases (MEDLINE, SciELO and Cochrane) were carefully analyzed. The consensus for each question was obtained by a vote of experts on the specific theme. RESULTS: Recommendations were made, including indications for the use of transcranial Doppler according to the sickle cell disease genotype and patients age; the necessary conditions to perform the exam and its periodicity depending on exam results; the criteria for the indication of blood transfusions and iron chelation therapy; the indication of hydroxyurea; and the therapeutic approach in cases of conditional transcranial Doppler. CONCLUSION: The Brazilian guidelines on the use of transcranial doppler in sickle cell disease patients may reduce the risk of strokes, and thus reduce the morbidity and mortality and improve the quality of life of sickle cell disease patients.
Sujets)
Humains , Mâle , Femelle , Nourrisson , Enfant d'âge préscolaire , Enfant , Adolescent , Hémoglobine S , Enfant , Adolescent , Directives , Échographie-doppler transcrânienne/méthodes , Accident vasculaire cérébral/prévention et contrôle , Drépanocytose/diagnostic , Drépanocytose/thérapieRésumé
The results of studies of strokes in children who are sickle cell anemia carriers are presented in this work. The roles of transfusions and transcranial Doppler to predict patients with a high risk of having a stroke are emphasized.
Neste relato são apresentados os resultados de estudos de acidente vascular cerebral em crianças portadoras de anemia falciforme. É enfatizado o papel das transfusões e do doppler transcraniano em predizer quais os pacientes que encontram-se sob risco de apresentarem acidente vascular cerebral.