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Silent Stroke in a Case of ß-Thalassemia Major Associated With Chronic Renal Failure and Diabetes Mellitus

Department of Pediatrics Yüzüncü Yl University Faculty of Medicine Van, Turkey, huseyincaksen{at}hotmail.com

Dursun Odaba, MD

Department of Pediatrics Yüzüncü Yl University Faculty of Medicine Van, Turkey

Sinan Akbayram, MD

Department of Pediatrics Yüzüncü Yl University Faculty of Medicine Van, Turkey

Ahmet Faik Öner, MD

Department of Pediatrics Yüzüncü Yl University Faculty of Medicine Van, Turkey

ükrü Arslan, MD

Department of Pediatrics Yüzüncü Yl University Faculty of Medicine Van, Turkey

Yaar Cesur, MD

Department of Pediatrics Yüzüncü Yl University Faculty of Medicine Van, Turkey

Abdurrahman Üner, MD

Department of Pediatrics Yüzüncü Yl University Faculty of Medicine Van, Turkey

Severe anemia, growth retardation, diabetes mellitus, cardiac disorders, and, infrequently, stroke are well-known complications of thalassemia major. We report a girl, age 7 years, 2 months, with ßthalassemia major associated with chronic renal failure, diabetes mellitus, and cardiomyopathy in whom a silent stroke was noted during follow-up. She was diagnosed with thalassemia major at age 6 months, chronic renal failure at age 3 years, 3 months, and diabetes mellitus and cardiomyopathy at age 7 years. Although cranial computed tomography was found to be normal at the age of 3 years, 3 months, magnetic resonance imaging showed cerebral infarct in the right frontal region at 7 years, 2 months. A thrombophilic panel revealed increased factor VIII and decreased protein C concentrations. She died from disseminated intravascular coagulation at age 7 years, 9 months. We did not record any clinical findings of stroke during her follow-up. We think that diabetes mellitus, dilated cardiomyopathy, and increased factor VIII and decreased protein C concentrations led to the occurrence of cerebral infarct. In conclusion, we emphasize that children with thalassemia major should be monitored closely for stroke. We also suggest that stroke can show a silent progression in severely affected children, as in our case. (J Child Neurol 2003;18:798—800).

Journal of Child Neurology, Vol. 18, No. 11, 798-800 (2003)
DOI: 10.1177/08830738030180110201


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