Brain Risk Seen in Sickle Cell Kids

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Brain Risk Seen in Sickle Cell Kids

A new study indicates that children with sickle cell anemia, already at risk of life-threatening infections and strokes, may also suffer significant neuropsychologic deficits. The researchers find that children inheriting the red blood cell disorder have lower IQs and more learning disabilities than do their siblings without the disease -- perhaps as a result of subtle brain damage during their first few years of life.

The study is small and awaits verification -- some of which may come from a federally funded trial now getting underway. If confirmed, the findings could radically alter the prevailing view of sickle cell pathology in children, which today generally attributes any lag in school progress to the psychological stresses and missed school days common among youngsters with the disease.

The research, described in the December PEDIATRICS, is the first published report on the topic since a 1963 study found no significant intellectual differences between sickle cell children and controls. But according to Andrea V. Swift, who led the new study, unpublished data hint that the gap between the two groups has widened during the past two decades. She notes that cognitive scores have remained stagnant in sickle cell kids as a group, while increasing in controls. Because the disease primarily strikes blacks, Swift's team suggests that improved educational opportunities for blacks in recent years may make cognitive differences in afflicted children more apparent.

Swift, then at the University of Georgia in Athens, used a palette of standard psychological tests to measure cognitive abilities in 21 children, 7 to 16 years old, with sickle cell anemia and no known history of neurologic disease. She compared their scores with those of siblings within the same age range who did not inherit the disease. The sickle cell group scored significantly lower than the control group on almost all cognitive measures, report Swift and her colleagues from the University of Georgia and the Medical College of Georgia in Augusta. …