IRON-DEFICIENCY ANEMIA IS ASSOCIATED WITH CEREBRAL SINOVENOUS THROMBOSIS: A CASE SERIES

Abstract

INTRODUCTION: Iron-deficiency anemia is a relatively common but preventable condition in children that may have significant adverse implications on children's growth and development. Iron-deficiency anemia has also been sporadically reported in association with cerebral sinovenous thrombosis (CSVT). OBJECTIVE: The objective of this study was to describe the largest case series to date of iron-deficiency anemia in association with CSVT as an advocacy measure for its prevention in children. METHODS: Patients were identified through the Canadian Pediatric Ischemic Stroke Registry database (Toronto site). Included were patients who were older than 1 month to 18 years, met criteria for iron-deficiency anemia, and had radiographically confirmed CSVT. RESULTS: Thirty-six patients who had CSVT and were older than 1 month to 18 years presented to the Hospital for Sick Children, Toronto, from January 2004 to December 2005. Six (17%) of these patients had iron-deficiency anemia; 2 were female adolescents, and 4 were male toddlers. All patients had historical and laboratory evidence of iron-deficiency anemia. Other risk factors, such as dehydration or inflammatory disorders, were present in all patients, but we did not detect significant inherited hypercoagulable disorders or acquired thrombophilia in any of them. CONCLUSIONS: This report strengthens the evidence of an association between iron-deficiency anemia and CSVT. We suggest that children who have CSVT should be screened for iron deficiency. Advocacy to prevent iron deficiency is important, because this condition may have serious long-term and irreversible developmental consequences.