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Asymptomatic brain magnetic resonance imaging abnormalities in splenectomized adults with thalassemia intermedia

Show simple item record Taher A.T. Musallam K.M. Nasreddine W. Hourani R. Inati A. Beydoun A.
dc.contributor.editor Jan-2010 2017-10-05T15:39:29Z 2017-10-05T15:39:29Z 2010
dc.identifier 10.1111/j.1538-7836.2009.03651.x
dc.identifier.issn 15387933
dc.description.abstract Background: A high incidence of thrombotic events in thalassemia intermedia (TI) patients led to the identification of a hypercoagulable state. Brain involvement has not been widely studied in TI, although limited reports confirm a low incidence of overt stroke and high incidence of silent brain infarcts. Patients-methods: This was a prospective study conducted on 30 adult, splenectomized TI patients. Patients were screened for absence of neurological signs or symptoms, and stroke-related risk factors. Patient charts were reviewed for demographics, duration since splenectomy, and any history of transfusion therapy. Blood samples were obtained for complete blood counts and serum ferritin. Direct determination of liver iron concentration (LIC) was performed by R2 magnetic resonance imaging (MRI). Brain MRI was performed on all patients, looking for ischemic lesions and-or atrophy. Results: The mean age of patients was 32.1 ± 11 years (range, 18-54 years), with a male to female ratio of 13:17. Eighteen patients (60percent) had evidence of one or more white matter lesions (WMLs) on brain MRI, all involving the subcortical white matter. Fourteen patients had evidence of multiple WMLs, with a mean of 5 ± 10 lesions (range, 2 to 40 lesions). The vast majority of patients (94percent) had small ( 0.5 cm) to medium (0.5-1.5 cm) WMLs, with only one patient showing evidence of a large ( 1.5 cm) WML. Eleven patients (37percent) had mild cerebral atrophy. On multivariate analysis only age and transfusion history were independently and significantly associated with the occurrence of zero, single or multiple WMLs. Conclusion: WMLs and brain atrophy are a common finding in adult, splenectomized, TI patients. Increasing age and transfusion naivety are associated with a higher incidence and multiplicity of lesions. © 2009 International Society on Thrombosis and Haemostasis.
dc.format.extent Pages: (54-59)
dc.language English
dc.publisher MALDEN
dc.relation.ispartof Publication Name: Journal of Thrombosis and Haemostasis; Publication Year: 2010; Volume: 8; no. 1; Pages: (54-59);
dc.source Scopus
dc.title Asymptomatic brain magnetic resonance imaging abnormalities in splenectomized adults with thalassemia intermedia
dc.type Article
dc.contributor.affiliation Taher, A.T., Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Musallam, K.M., Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Nasreddine, W., Division of Neurology, Rafik Hariri University Hospital, Beirut, Lebanon
dc.contributor.affiliation Hourani, R., Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Inati, A., Division of Pediatric Hematology and Oncology, Children's Center for Cancer and Blood Diseases, Rafik Hariri University Hospital, Beirut, Lebanon
dc.contributor.affiliation Beydoun, A., Department of Internal Medicine, Division of Neurology, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.authorAddress Taher, A.T.; Department of Internal Medicine, American University of Beirut Medical Center, PO Box 11-0236, Riad El-Solh, 1107 2020, Beirut, Lebanon; email:
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine; Division: Neurology;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorDivision Neurology
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Taher, AT
dc.contributor.authorInitials Musallam, KM
dc.contributor.authorInitials Nasreddine, W
dc.contributor.authorInitials Hourani, R
dc.contributor.authorInitials Inati, A
dc.contributor.authorInitials Beydoun, A
dc.contributor.authorReprintAddress Taher, AT (reprint author), Amer Univ Beirut, Div Hematol and Oncol, Dept Internal Med, Med Ctr, POB 11-0236, Beirut 11072020, Lebanon.
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedCount 31
dc.description.citedTotWOSCount 34
dc.description.citedWOSCount 32
dc.format.extentCount 6
dc.identifier.coden JTHOA
dc.identifier.pubmedID 19817994
dc.identifier.scopusID 73049084139
dc.publisher.address COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA
dc.relation.ispartOfISOAbbr J. Thromb. Haemost.
dc.relation.ispartOfIssue 1
dc.relation.ispartofPubTitle Journal of Thrombosis and Haemostasis
dc.relation.ispartofPubTitleAbbr J. Thromb. Haemost.
dc.relation.ispartOfVolume 8
dc.source.ID WOS:000272864200010
dc.type.publication Journal
dc.subject.otherAuthKeyword Brain
dc.subject.otherAuthKeyword Splenectomy
dc.subject.otherAuthKeyword Stroke
dc.subject.otherAuthKeyword Thalassemia intermedia
dc.subject.otherAuthKeyword Transfusion
dc.subject.otherAuthKeyword White matter lesion
dc.subject.otherChemCAS hemoglobin F, 9034-63-3
dc.subject.otherIndex hemoglobin F
dc.subject.otherIndex adult
dc.subject.otherIndex age
dc.subject.otherIndex article
dc.subject.otherIndex blood transfusion
dc.subject.otherIndex brain atrophy
dc.subject.otherIndex brain infarction
dc.subject.otherIndex brain ischemia
dc.subject.otherIndex cerebrovascular accident
dc.subject.otherIndex clinical article
dc.subject.otherIndex controlled study
dc.subject.otherIndex female
dc.subject.otherIndex ferritin blood level
dc.subject.otherIndex hemoglobin blood level
dc.subject.otherIndex human
dc.subject.otherIndex incidence
dc.subject.otherIndex liver level
dc.subject.otherIndex male
dc.subject.otherIndex nuclear magnetic resonance imaging
dc.subject.otherIndex priority journal
dc.subject.otherIndex risk factor
dc.subject.otherIndex splenectomy
dc.subject.otherIndex thalassemia
dc.subject.otherIndex thalassemia intermedia
dc.subject.otherIndex thrombocyte count
dc.subject.otherIndex white matter
dc.subject.otherIndex Adolescent
dc.subject.otherIndex Adult
dc.subject.otherIndex Age Factors
dc.subject.otherIndex Atrophy
dc.subject.otherIndex Blood Transfusion
dc.subject.otherIndex Brain
dc.subject.otherIndex Brain Ischemia
dc.subject.otherIndex Chi-Square Distribution
dc.subject.otherIndex Diffusion Magnetic Resonance Imaging
dc.subject.otherIndex Female
dc.subject.otherIndex Humans
dc.subject.otherIndex Incidence
dc.subject.otherIndex Lebanon
dc.subject.otherIndex Logistic Models
dc.subject.otherIndex Male
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Prospective Studies
dc.subject.otherIndex Risk Assessment
dc.subject.otherIndex Risk Factors
dc.subject.otherIndex Splenectomy
dc.subject.otherIndex Thalassemia
dc.subject.otherIndex Young Adult
dc.subject.otherKeywordPlus RED-BLOOD-CELLS
dc.subject.otherKeywordPlus AUSTRIAN STROKE PREVENTION
dc.subject.otherKeywordPlus LIVER IRON CONCENTRATIONS
dc.subject.otherKeywordPlus BETA-THALASSEMIA
dc.subject.otherKeywordPlus INCIDENTAL FINDINGS
dc.subject.otherKeywordPlus HYPERCOAGULABLE STATE
dc.subject.otherKeywordPlus ELDERLY INDIVIDUALS
dc.subject.otherKeywordPlus PREVALENCE
dc.subject.otherKeywordPlus ANEMIA
dc.subject.otherWOS Hematology
dc.subject.otherWOS Peripheral Vascular Disease

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