Document Detail


Comparison of real-time microvascular abnormalities in pediatric and adult sickle cell anemia patients.
MedLine Citation:
PMID:  20872552     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The conjunctival microcirculation in 14 pediatric and eight adult sickle cell anemia (SCA) patients was studied using computer-assisted intravital microscopy. The bulbar conjunctiva in SCA patients in both age groups exhibited a blanched/avascular appearance characterized by decreased vascularity. SCA patients from both age groups had many of the same abnormal morphometric [vessel diameter, vessel distribution, morphometry (shape), tortuosity, arteriole:venule (A:V) ratio, and hemosiderin deposits] and dynamic [vessel sludging/sludged flow, boxcar blood (trickled) flow, and abnormal flow velocity] abnormalities. A severity index (SI) was computed to quantify the degree of vasculopathy for comparison between groups. The severity of vasculopathy differed significantly between the pediatric and adult patients (SI: 4.2 ± 1.8 vs. 6.6 ± 2.4; P = 0.028), indicative of a lesser degree of overall severity in the pediatric patients. Specific abnormalities that were less prominent in the pediatric patients included abnormal vessel morphometry and tortuosity. Sludged flow, abnormal vessel distribution, abnormal A:V ratio, and boxcar flow appeared in high prevalence in both age groups. The results indicate that SCA microvascular abnormalities develop in childhood and the severity of vasculopathy likely progresses with age. Intervention and effective treatment/management modalities should target pediatric patients to ameliorate, slow down, or prevent progressive microvascular deterioration.
Authors:
Anthony T W Cheung; Joshua W Miller; Sarah M Craig; Patricia L To; Xin Lin; Sandra L Samarron; Peter C Y Chen; Theodore Zwerdling; Ted Wun; Chin-Shang Li; Ralph Green
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  American journal of hematology     Volume:  85     ISSN:  1096-8652     ISO Abbreviation:  Am. J. Hematol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-26     Completed Date:  2010-12-10     Revised Date:  2014-09-13    
Medline Journal Info:
Nlm Unique ID:  7610369     Medline TA:  Am J Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  899-901     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley-Liss, Inc.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Anemia, Sickle Cell / physiopathology*
Blood Flow Velocity
Child
Conjunctiva / blood supply
Humans
Microcirculation
Microvessels / pathology*,  physiopathology
Middle Aged
Grant Support
ID/Acronym/Agency:
R01 HL083276/HL/NHLBI NIH HHS; R01 HL083276-04/HL/NHLBI NIH HHS; R01 HL83276/HL/NHLBI NIH HHS; UL1-RR024146/RR/NCRR NIH HHS
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