Complicações clínicas em crianças portadoras de anemia falciforme com hipertrofia de tonsilas faríngea e palatinas com indicação cirúrgica

Abstract

Objective: To evaluate whether patients with sickle cell anemia (SCA), between 3 and 12 years with an indication for tonsillectomy are more amenable to clinical complications. Method: Cross-sectional study of 107 patients with AF, between 3 and 12 years. Parents answered standardized questions (interview) that indicate surgery for tonsils. Eligible patients were referred for ENT evaluation, including oral and videonasofibroscopy, a procedure that identified the group surgical candidate. Done this, we identified, among patients not candidates for surgery, those equals by sex and age with surgery candidates, with a ratio of 1:1 matching, comparing them according to age at diagnosis, accident occurrence stroke (CVA), mean annual frequency of admissions for painful crises, use of hydroxyurea, and mean annual hemoglobin, leukocytes and platelets. The comparison between groups was performed using the chi-square or Fisher exact test for proportional variables, and "t" test for independent continuous variables (p <.05). Results: Of 107 patients identified, 70 of them were interviewed those responsible. Of these, surgery was indicated in 16 (22.8%), and conduct confirmed in 14 patients and 2 was made to family choice for clinical treatment. The case and control groups had respective average annual admissions for painful crises of 0.93 and 0.375 (p = 0.076) and the occurrence of stroke in 5 cases (31.2%) in the case group and zero in the control group (p = 0.021). There was no difference between the groups when comparing variables: mean annual hemoglobin, leukocytes and platelets, and the use of hydroxyurea. Conclusion: This study indicated patients with surgical indications had stroke frequency higher than the group without surgical indication. It was also observed that the average annual hospitalizations for painful crises in the study group was three times that observed in the control group, although without statistical significance.