Acute Ischemic Stroke in Sickle Cell Disease Challenges for Thrombolysis

Sickle cell disease (SCD) is a hemoglobinopathy disorder that was recognized in 1949. Stroke is one of the most devastating complications of this disorder. The risk of stroke in SCD patients varies with the genotype; the highest rate has been reported with hemoglobin S. Tissue type plasminogen activ...

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Main Authors: Amal Al Hashmi, Sanjith Aaron
Format: Article
Language:English
Published: Knowledge E 2020-10-01
Series:Dubai Medical Journal
Subjects:
Online Access:https://www.karger.com/Article/FullText/510873
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author Amal Al Hashmi
Sanjith Aaron
author_facet Amal Al Hashmi
Sanjith Aaron
author_sort Amal Al Hashmi
collection DOAJ
description Sickle cell disease (SCD) is a hemoglobinopathy disorder that was recognized in 1949. Stroke is one of the most devastating complications of this disorder. The risk of stroke in SCD patients varies with the genotype; the highest rate has been reported with hemoglobin S. Tissue type plasminogen activator (t PA) is class I recommended therapy for acute ischemic stroke (AIS) since 1996. Although it is unclear if SCD patients were included in the t PA trail, SCD has never been identified as contraindication. The debate of offering t PA for adult SCD patient presenting with AIS continued for at least 2 decades. It is not up and until 2 years ago when the American Heart Association and American stroke association (AHA/ASA) announced that intravenous (IV) t PA can be offered to adult SCD patients presenting with AIS. Here, we report a case where successful IV thrombolytic therapy was offered to an adult SCD patient presenting with AIS with excellent outcome.
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spelling doaj-art-938fc2500d5e4695a090173df8e8f1052025-08-20T02:56:09ZengKnowledge EDubai Medical Journal2571-726X2020-10-011510.1159/000510873510873Acute Ischemic Stroke in Sickle Cell Disease Challenges for ThrombolysisAmal Al HashmiSanjith AaronSickle cell disease (SCD) is a hemoglobinopathy disorder that was recognized in 1949. Stroke is one of the most devastating complications of this disorder. The risk of stroke in SCD patients varies with the genotype; the highest rate has been reported with hemoglobin S. Tissue type plasminogen activator (t PA) is class I recommended therapy for acute ischemic stroke (AIS) since 1996. Although it is unclear if SCD patients were included in the t PA trail, SCD has never been identified as contraindication. The debate of offering t PA for adult SCD patient presenting with AIS continued for at least 2 decades. It is not up and until 2 years ago when the American Heart Association and American stroke association (AHA/ASA) announced that intravenous (IV) t PA can be offered to adult SCD patients presenting with AIS. Here, we report a case where successful IV thrombolytic therapy was offered to an adult SCD patient presenting with AIS with excellent outcome.https://www.karger.com/Article/FullText/510873bloodhematologyneurologysickle cell diseasehemoglobinopathyacute ischemic strokemanagementthrombolysistissue type plasminogen activatorstroke mimicsomantreatmentvascular
spellingShingle Amal Al Hashmi
Sanjith Aaron
Acute Ischemic Stroke in Sickle Cell Disease Challenges for Thrombolysis
Dubai Medical Journal
blood
hematology
neurology
sickle cell disease
hemoglobinopathy
acute ischemic stroke
management
thrombolysis
tissue type plasminogen activator
stroke mimics
oman
treatment
vascular
title Acute Ischemic Stroke in Sickle Cell Disease Challenges for Thrombolysis
title_full Acute Ischemic Stroke in Sickle Cell Disease Challenges for Thrombolysis
title_fullStr Acute Ischemic Stroke in Sickle Cell Disease Challenges for Thrombolysis
title_full_unstemmed Acute Ischemic Stroke in Sickle Cell Disease Challenges for Thrombolysis
title_short Acute Ischemic Stroke in Sickle Cell Disease Challenges for Thrombolysis
title_sort acute ischemic stroke in sickle cell disease challenges for thrombolysis
topic blood
hematology
neurology
sickle cell disease
hemoglobinopathy
acute ischemic stroke
management
thrombolysis
tissue type plasminogen activator
stroke mimics
oman
treatment
vascular
url https://www.karger.com/Article/FullText/510873
work_keys_str_mv AT amalalhashmi acuteischemicstrokeinsicklecelldiseasechallengesforthrombolysis
AT sanjithaaron acuteischemicstrokeinsicklecelldiseasechallengesforthrombolysis