Sickle cell disease, stroke risk

The risk factors for vascular dementia are essentially the same as those for stroke and heart attack. They include high blood pressure, heart disease, diabetes mellitus, sickle cell disease, obesity, smoking, alcohol use, depression, and high cholesterol levels. 

Some of the clinical consequences in SS disease include megaloblastic erythropoiesis, aplastic crisis, stroke, bone pain crisis, proneness to infection particularly by Pneumococcus, Salmonella, and Haemophilus due to hypos-plenism and acute chest syndrome. Prophylactic use of penicillin and antipneumococcal and Haemophilus vaccines has aided in the management of life-threatening infectious complications of SS disease. Neonatal screening has been used in the identification of infants with sickle cell disease so that risk of infection can be modulated by appropriate immunizations and penicillin prophylaxis. The acute chest syndrome characterized by chest pain is due to clogged pulmonary capillaries in a small number of studies, patients have been treated with inhaled nitric oxide, which dilates blood vessels with clinical improvement. 

Miller ST, MackUn EA, Pegelow CH, et al. Silent infarction as a risk factor for overt stroke in children with sickle cell anemia A report from the Cooperative Study of Sickle Cell Disease. J Pediatr 2001 139 385-390. 

Scothorn DJ, Price C, Schawartz D, et al. Risk of recurrent stroke in children with sickle cell disease receiving blood transfusion therapy for at least five years after initial stroke. J Pediatr 2002 140 348-354. 

A family medical history can identify people with a higher-than-usual chance of having common disorders, such as heart disease, high blood pressure, stroke, certain cancers, and diabetes. These complex disorders are influenced by a combination of genetic factors, environmental conditions, and lifestyle choices. A family history also can provide information about the risk of rarer conditions caused by mutations in a single gene, such as cystic fibrosis and sickle cell anemia. 

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