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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Knowledge E
2020-10-01
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| Series: | Dubai Medical Journal |
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| 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. |
| format | Article |
| id | doaj-art-938fc2500d5e4695a090173df8e8f105 |
| institution | DOAJ |
| issn | 2571-726X |
| language | English |
| publishDate | 2020-10-01 |
| publisher | Knowledge E |
| record_format | Article |
| series | Dubai Medical Journal |
| 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 |