Abdominal ultrasound with scintigraphic and clinical correlates in infants with sickle cell anemia

Baseline data from the BABY HUG trial

M. Beth McCarville, Zhaoyu Luo, Xiangke Huang, Renee C. Rees, Zora R. Rogers, Scott T. Miller, Bruce Thompson, Ram Kalpatthi, Winfred C. Wang

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study is to perform and evaluate baseline abdominal ultrasound in infants with sickle cell anemia who participated in the BABY HUG multiinstitutional randomized placebo-controlled trial of hydroxyurea therapy and to examine the potential relationships among ultrasound results and clinical, nuclear medicine, and laboratory data. SUBJECTS AND METHODS. After local institutional review board approval and with informed guardian consent, 116 girls and 87 boys (age range, 7.5-18 months) with sickle cell anemia underwent standardized abdominal sonography at 14 institutions. Imaging was centrally reviewed by one radiologist who assessed and measured the spleen, kidneys, gallbladder, and common bile duct. Baseline physical assessment of spleen size, serum alanine aminotransferase and bilirubin levels, 99mTc sulfur colloid liver-spleen scans, and 99mTc diethylenetriaminepentaacetic acid clearance glomerular filtration rates (GFRs) were obtained. Analysis of variance and the Student test were performed to compare sonographic findings to published results in healthy children and to clinical and laboratory findings. RESULTS. The mean (± SD) spleen volume (108 ± 47 mL) was significantly greater than published normal control values (30 ± 14 mL; p < 0.0001). There was no correlation between spleen volume and function assessed by liver-spleen scan. The mean GFR (125 ± 34 mL/min/1.73 m2) was elevated compared with control GFRs (92 ± 18 mL/min/1.73 m2). Renal volumes (right kidney, 29 ± 8 mL; left kidney, 31 ± 9 mL) were significantly greater than control volumes (right kidney, 27 ± 3 mL; left kidney, 27 ± 3 mL; p < 0.0001) and were positively correlated with GFR (p = 0.0009). Five percent of patients had sonographic biliary abnormalities (sludge, n = 6; dilated common bile duct, n = 2; and cholelithiasis and thickened gallbladder wall, n = 1 each). There was no correlation between biliary sonographic findings and laboratory results. CONCLUSION. In infants with sickle cell anemia, sonographic spleen volume does not reflect function, but increased renal volume correlates with GFR and is consistent with hyperfiltration. Sonographic biliary abnormalities can occur early in life, while remaining clinically silent.

Original languageEnglish (US)
Pages (from-to)1399-1404
Number of pages6
JournalAmerican Journal of Roentgenology
Volume196
Issue number6
DOIs
StatePublished - Jun 2011

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Sickle Cell Anemia
Spleen
Glomerular Filtration Rate
Kidney
Common Bile Duct
Gallbladder
Cholelithiasis
Hydroxyurea
Research Ethics Committees
Liver
Clinical Medicine
Nuclear Medicine
Colloids
Informed Consent
Alanine Transaminase
Bilirubin
Sulfur
Bile
Ultrasonography
Analysis of Variance

Keywords

  • Abdominal ultrasound
  • Children
  • Kidneys
  • Sickle cell anemia
  • Spleen

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Abdominal ultrasound with scintigraphic and clinical correlates in infants with sickle cell anemia : Baseline data from the BABY HUG trial. / McCarville, M. Beth; Luo, Zhaoyu; Huang, Xiangke; Rees, Renee C.; Rogers, Zora R.; Miller, Scott T.; Thompson, Bruce; Kalpatthi, Ram; Wang, Winfred C.

In: American Journal of Roentgenology, Vol. 196, No. 6, 06.2011, p. 1399-1404.

Research output: Contribution to journalArticle

McCarville, M. Beth ; Luo, Zhaoyu ; Huang, Xiangke ; Rees, Renee C. ; Rogers, Zora R. ; Miller, Scott T. ; Thompson, Bruce ; Kalpatthi, Ram ; Wang, Winfred C. / Abdominal ultrasound with scintigraphic and clinical correlates in infants with sickle cell anemia : Baseline data from the BABY HUG trial. In: American Journal of Roentgenology. 2011 ; Vol. 196, No. 6. pp. 1399-1404.
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abstract = "OBJECTIVE. The purpose of this study is to perform and evaluate baseline abdominal ultrasound in infants with sickle cell anemia who participated in the BABY HUG multiinstitutional randomized placebo-controlled trial of hydroxyurea therapy and to examine the potential relationships among ultrasound results and clinical, nuclear medicine, and laboratory data. SUBJECTS AND METHODS. After local institutional review board approval and with informed guardian consent, 116 girls and 87 boys (age range, 7.5-18 months) with sickle cell anemia underwent standardized abdominal sonography at 14 institutions. Imaging was centrally reviewed by one radiologist who assessed and measured the spleen, kidneys, gallbladder, and common bile duct. Baseline physical assessment of spleen size, serum alanine aminotransferase and bilirubin levels, 99mTc sulfur colloid liver-spleen scans, and 99mTc diethylenetriaminepentaacetic acid clearance glomerular filtration rates (GFRs) were obtained. Analysis of variance and the Student test were performed to compare sonographic findings to published results in healthy children and to clinical and laboratory findings. RESULTS. The mean (± SD) spleen volume (108 ± 47 mL) was significantly greater than published normal control values (30 ± 14 mL; p < 0.0001). There was no correlation between spleen volume and function assessed by liver-spleen scan. The mean GFR (125 ± 34 mL/min/1.73 m2) was elevated compared with control GFRs (92 ± 18 mL/min/1.73 m2). Renal volumes (right kidney, 29 ± 8 mL; left kidney, 31 ± 9 mL) were significantly greater than control volumes (right kidney, 27 ± 3 mL; left kidney, 27 ± 3 mL; p < 0.0001) and were positively correlated with GFR (p = 0.0009). Five percent of patients had sonographic biliary abnormalities (sludge, n = 6; dilated common bile duct, n = 2; and cholelithiasis and thickened gallbladder wall, n = 1 each). There was no correlation between biliary sonographic findings and laboratory results. CONCLUSION. In infants with sickle cell anemia, sonographic spleen volume does not reflect function, but increased renal volume correlates with GFR and is consistent with hyperfiltration. Sonographic biliary abnormalities can occur early in life, while remaining clinically silent.",
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