Venous sinus thrombosis leading to stroke in a patient with sickle cell disease on hydroxyurea and high hemoglobin levels: Treatment with thrombolysis

A 21‐year‐old man with homozygous sickle cell disease maintained on hydroxyurea for 1 year developed thrombosis of the superior sagittal, right transverse, and right sigmoid dural sinuses with a large venous infarct. He was successfully treated with endovascular thrombolysis. Investigation did not r...

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Bibliographic Details
Published in:American journal of hematology 2008-10, Vol.83 (10), p.818-820
Main Authors: Sidani, Charif A., Ballourah, Walid, El Dassouki, Mohamad, Muwakkit, Samar, Dabbous, Ibrahim, Dahoui, Hanan, Al‐Kutoubi, Aghiad, Abboud, Miguel R.
Format: Article
Language:English
Subjects:
Adult
Anemia, Sickle Cell - drug therapy
Anemia, Sickle Cell - genetics
Anemias. Hemoglobinopathies
Antisickling Agents - therapeutic use
Biological and medical sciences
Blood and lymphatic vessels
Brain Infarction - diagnostic imaging
Cardiology. Vascular system
Diseases of red blood cells
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Dura Mater - blood supply
Follow-Up Studies
Hematologic and hematopoietic diseases
Hemoglobins - analysis
Hip - diagnostic imaging
Hip - pathology
Homozygote
Humans
Hydroxyurea - therapeutic use
Male
Medical sciences
Osteonecrosis - complications
Osteonecrosis - diagnostic imaging
Osteonecrosis - pathology
Radiography
Sinus Thrombosis, Intracranial - diagnostic imaging
Sinus Thrombosis, Intracranial - drug therapy
Stroke - drug therapy
Stroke - etiology
Thrombolytic Therapy
Time Factors
Treatment Outcome
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Summary:A 21‐year‐old man with homozygous sickle cell disease maintained on hydroxyurea for 1 year developed thrombosis of the superior sagittal, right transverse, and right sigmoid dural sinuses with a large venous infarct. He was successfully treated with endovascular thrombolysis. Investigation did not reveal any inherited or acquired hypercoagulable state. This patient however had consistently elevated hemoglobin levels both at the time of the initial event and on follow up. One year later he developed symptomatic avascular necrosis of the right hip. High hemoglobin levels resulting from hydroxyurea therapy may have contributed to development of complications in this patient. Am. J. Hematol., 2008. © 2008 Wiley‐Liss, Inc.
ISSN:0361-8609
1096-8652
DOI:10.1002/ajh.21261