Abstract Details

Title Ischemic Stroke Related to Severe Iron-Deficiency Anemia in Adults May Benefit from Blood Transfusion

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P01 - (-)

Poster/Presentation
Number 232

Objective

Background BACKGROUND: IDA is the most common nutritional deficiency worldwide. IDA is associated with AIS in healthy pediatric populations through arterial and venous occlusion via reactive thromobocytosis. There are various case reports of venous occlusion related to IDA in adults, but limited literature regarding IDA associated AIS.

Design/Methods DESIGN/METHODS: AIS patients with Hct <28% from July 2004 through March 2012 were identified from our stroke registry. Retrospective chart analysis was done to select patients with severe IDA defined by Hgb <10 g/dL with MCV <75 fL or ferritin <15 mcg/L or transferrin saturation <5%. Demographics, etiology, TPA treatment, MRI, blood transfusion, and cause of IDA were obtained.

Results RESULTS: Among 4,477 AIS patients, 147 subjects had Hct <28% and 39 met the criteria for severe IDA. Stroke mechanism could not be identified in 18 patients; median age 46.5 (±15) and 16 female and 2 male. 17 had positive DWI lesions and 1 unable to obtain MRI. 9 subjects received TPA; 1 had hemorrhagic transformation without TPA treatment. 61% IDA causes were from either menorrhagia or leiomyoma and 39% were either unknown or sickle cell disease. 14 subjects received RBC transfusion and 3 of 14 had resolution of deficit post-transfusion.

Conclusions CONCLUSIONS: Prevalence of IDA is 1-20%; it is 3.9% in our AIS population and is often related to untreated uterine bleeding. As described in the pediatric population, severe IDA may be an underlying mechanism of ischemic stroke in adults, therefore, efforts must be undertaken to identify and treat the cause of the anemia. While patients with AIS and severe IDA may receive TPA, blood transfusion may be considered as an adjuvant therapy.

Authors/Disclosures
Ellie E. Choi, MD (Overlake Neuroscience Institute) PRESENTER	No disclosure on file
	No disclosure on file
Nicole Gonzales, MD (University of Colorado Anschutz Medical Campus)	The institution of Dr. Gonzales has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology.
Lahar R. Mehta, MD	Dr. Mehta has received personal compensation for serving as an employee of Amylyx Pharmaceuticals.

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