Abstract
Sickle cell anemia (SCA) is an inherited autosomal recessive disease. It is caused due to point mutation that substitutes glutamate with valine at the sixth amino acid position of the beta chain of hemoglobin molecules leading to the sickling of the red blood cells and decreased structural deformability. Silent cerebral infarcts are the most common neurological complication of SCA, while overt stroke comprises substantial burden in patients with SCA. This meta-analysis aimed to find the pooled prevalence of overt stroke in SCA patients and discuss the importance of screening them. PubMed, Embase, and Google Scholar were the electronic databases used to search the studies. A total of 765 articles were retrieved upon detailed searching in the abovementioned databases. After a series of removing duplicate articles, title and abstract screening, and full-text review, 20 articles were found eligible and included in the study. The total number of participants from all the included studies was 3,956, and pooled prevalence of stroke in patients with sickle cell anemia in Asia was found to be 5% (95% CI: 4%, 6%) with a range from 1 to 41%. Stroke occurrence in sickle cell anemia patients is an emergency complication that needs immediate intervention and management. Because of the high prevalence of stroke in patients with sickle cell anemia, clinicians should focus on its prevention and treatment strategies.
Highlights
Sickle cell disease is a group of inherited red blood cell disorders that affects the oxygen-carrying protein, hemoglobin; of which, the most common type is known as sickle cell anemia (SCA)
We systematically review articles highlighting the prevalence of stroke in patients with sickle cell anemia in Asia and estimate the pooled prevalence of overt stroke in them. is review tried to summarize the prevalence of stroke in Sickle cell anemia (SCA) patients in Asia as the greatest burden of SCA is seen in Africa and Asia, and no study has reported it from Asia
Our analysis found the prevalence of stroke in sickle cell anemia to be 5% ranging 1%–41% between the studies
Summary
Sickle cell disease is a group of inherited red blood cell disorders that affects the oxygen-carrying protein, hemoglobin; of which, the most common type is known as sickle cell anemia (SCA). It results in alteration in the shape and function of hemoglobin. E pathophysiology of stroke in such patients includes the occlusion of blood vessels by trapping of sickled blood vessels and the Neurology Research International hypercoagulable state. It can cause flow-related injury to the endothelial cells causing increased adhesiveness of sickle cell to them and may lead to stroke [10]
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