ASSOCIATION OF ANEMIA WITH ISCHEMIC STROKE IN PAEDIATRIC AGE
Main Article Content
Keywords
Anemia, Association, Ischemic Stroke, Logistic Regression, Pediatrics, Severity
Abstract
Background: Pediatric ischemic stroke is a rare but severe neurological condition, often associated with long-term disability. Anemia, a common condition in children, may increase stroke risk by impairing oxygen delivery to the brain and altering hemodynamics.
Objective: To evaluate the association between anemia and ischemic stroke severity in pediatric patients.
Study Design and Setting: A cross-sectional study conducted at DHQ Hospital Sheikupura over six months.
Methodology: A total of 130 pediatric patients with ischemic stroke were enrolled. Anemia was defined based on WHO hemoglobin criteria. Data on clinical presentation, neuroimaging findings, and hemoglobin levels were collected. Logistic regression analysis was performed to assess the association between anemia and stroke severity.
Results: Anemia was present in 61.5% of the patients, with 25% having severe anemia. Anemic patients had significantly higher odds of severe stroke (OR: 4.2, 95% CI: 2.1–8.0, p<0.001) compared to non-anemic patients. Multiple infarcts were more prevalent in anemic patients (28.7% vs. 12%, p=0.02).
Conclusion: Anemia is significantly associated with increased severity of ischemic stroke in pediatric patients. Addressing anemia could be a critical step in reducing stroke-related morbidity in children.
References
2. Poisson SN, Hills NK, Sidney S, Fullerton HJ. Prevalence of atherosclerotic risk factors among children and young adults with arterial ischemic stroke. JAMA neurology. 2022 Sep 1;79(9):901-10.
3. Yahya T, Jilani MH, Khan SU, Mszar R, Hassan SZ, Blaha MJ, Blankstein R, Virani SS, Johansen MC, Vahidy F, Cainzos-Achirica M. Stroke in young adults: Current trends, opportunities for prevention and pathways forward. American journal of preventive cardiology. 2020 Sep 1;3:100085.
4. Sporns PB, Fullerton HJ, Lee S, Kim H, Lo WD, Mackay MT, Wildgruber M. Childhood stroke. Nature Reviews Disease Primers. 2022 Feb 24;8(1):12.
5. Sporns PB, Fullerton HJ, Lee S, Kirton A, Wildgruber M. Current treatment for childhood arterial ischaemic stroke. The Lancet Child & Adolescent Health. 2021 Nov 1;5(11):825-36.
6. Sun LR, Lynch JK. Advances in the diagnosis and treatment of pediatric arterial ischemic stroke. Neurotherapeutics. 2023 Apr 1;20(3):633-54.
7. Ma Z, He W, Zhou Y, Mai L, Xu L, Li C, Li M. Global burden of stroke in adolescents and young adults (aged 15–39 years) from 1990 to 2019: a comprehensive trend analysis based on the global burden of disease study 2019. BMC Public Health. 2024 Jul 30;24(1):2042.
8. Sundelin H, Söderling J, Bang P, Bolk J. Risk of autism after pediatric ischemic stroke: a nationwide cohort study. Neurology. 2022 May 10;98(19):e1953-63.
9. Testai FD, Gorelick PB, Chuang PY, Dai X, Furie KL, Gottesman RF, Iturrizaga JC, Lazar RM, Russo AM, Seshadri S, Wan EY. Cardiac Contributions to Brain Health: A Scientific Statement From the American Heart Association. Stroke. 2024 Oct 10.
10. Fox C. Pediatric ischemic stroke. CONTINUUM: Lifelong Learning in Neurology. 2020 Apr 1;29(2):566-83.
11. Jankovic M, Petrovic B, Novakovic I, Brankovic S, Radosavljevic N, Nikolic D. The genetic basis of strokes in pediatric populations and insight into new therapeutic options. International Journal of Molecular Sciences. 2022 Jan 29;23(3):1601.
12. Mustafa M, Amawi M, Altoonisi MM, Soliman W, Kamal M, Asaad Z, Albalawi A, Alharbi J, Awadalla AM, Mohamed A, Ahmed A. Beyond Ischemia: The Rare Occurrence of Hemorrhagic Strokes in Pediatric Sickle Cell Anemia. Cureus. 2024 Oct 5;16(10):e70871.
13. Hebbel RP, Belcher JD, Vercellotti GM. The multifaceted role of ischemia/reperfusion in sickle cell anemia. The Journal of Clinical Investigation. 2020 Mar 2;130(3):1062-72.
14. Munot P, De Vile C, Hemingway C, Gunny R, Ganesan V. Severe iron deficiency anaemia and ischaemic stroke in children. Archives of disease in childhood. 2011 Mar 1;96(3):276-9.
15. Nawaz Z, Tahir SA, Mobin A, Kashif SM, Khuda IE. Frequency of Iron Deficiency Anemia in Ischemic Stroke. Annals Of Abbasi Shaheed Hospital And Karachi Medical & Dental College. 2022 May 30;28(2):88-95.
16. Mansoor R, Lodhi MW, Zafar H, Haider S, Sattar RA. Iron Deficiency Anemia Predisposing to Acute Ischemic Stroke–Is there a Need for more Aggressive Approach?. Archives of Internal Medicine Research. 2022;5(4):466-70.
17. Maguire JL, deveber G, Parkin PC. Association between iron-deficiency anemia and stroke in young children. Pediatrics. 2007 Nov 1;120(5):1053-7.
18. Awad D, Kousa O, Essa A, Kuniyoshi J, Kousa H, Qasim A, Andukuri V, Kassim T. Acute ischemic stroke as initial manifestation of undiagnosed iron deficiency anemia: case-report and literature review. AME case reports. 2020;4.
19. Hartfield DS, Lowry NJ, Keene DL, Yager JY. Iron deficiency: a cause of stroke in infants and children. Pediatric neurology. 2000 Jan 1;16(1):50-3.
20. Rathore RA, Butt NF, Iqbal AD, Latif HI, Azeem MA, Abbas MA. Association of Iron Deficiency Anemia with Stroke Severity in Patients with Acute Ischemic Stroke. J Med Heal Sci. 2021;15(11):3004-6.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Saba Tariq
MBBS, FCPS Pediatric WMO, DHQ Hospital Sheikupura Pediatric Department,
Iqbal Ahmad
Associate Professor Pediatric Medicine Shahida Islam Medical college, Lodhran
Manzoor Ali Khan
Assistant Professor Pediatric AJKMC,
Neelum Khan
Senior Registrar, Fauji Foundation Hospital Shalamar Hospital, Lahore
Nosheen Iftikhar
Associate Professor Paediatrics, Sharif Medical and Dental College, Lahore,
Ayesha Zahra Khan
MBBS and House Job from Sheikh Zayed Hospital, Lahore,