Brazilian Guidelines for transcranial doppler in children and adolescents with sickle cell disease

• Main Authors: Clarisse Lopes de Castro Lobo, Rodolfo Delfini Cançado, Ana Claudia Celestino Bezerra Leite, Ana Claudia Mendonça dos Anjos, Ana Cristina Silva Pinto, Andre Palma da Cunha Matta, Célia Maria Silva, Gisele Sampaio Silva, João Ricardo Friedrisch, Josefina Aparecida Pellegrini Braga, Marcos Christiano Lange, Maria Stella Figueiredo, Marília Álvares Rugani, Orlando Veloso, Patrícia Gomes Moura, Paulo Ivo Cortez, Robert Adams, Sandra Fátima Menosi Gualandro, Shirley Lopes de Castilho, Ursula Thomé, Viviane Flumignan Zetola
• Format: Article
• Language: English
• Published: Elsevier 2011-02-01
• Series: Revista Brasileira de Hematologia e Hemoterapia
• Subjects: Ultrasonography, doppler, transcranial; Anemia, sickle cell; Hemoglobin; Stroke; Child; Adolescent; Guideline
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842011000100014
• ISSN: 1516-8484; 1806-0870

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.