Learning Issues Children living with sickle cell disease may have brain damage that goes undetected. This damage can include narrowing of the blood vessels that supply the brain with blood or even silent strokes. Silent strokes are strokes that cause no physical symptoms but can be seen on a magnetic resonance imaging (MRI) scan or computed tomography (CT) scan of the brain. Also, like children who live with other chronic illnesses, children with sickle cell disease may miss many days of school and have days when they are not at their best. This can lead to learning challenges. It is recommended that children with sickle cell disease periodically undergo neuropsychological testing, a type of evaluation that determines a child’s strengths and weaknesses in learning. It is important to let your child’s doctor know if they are having learning challenges in school. Growth and Development Delays Ongoing anemia or chronic anemia (low measure your child regularly. If your child does not have any signs of puberty when expected or begins to fall behind the growth curve, they may refer your child to a growth and hormones specialist (endocrinologist). Skin Complications Leg ulcers are poorly healing skin sores typically found on the lower leg. They can occur in 10%–15% of older teen and adult patients who have sickle cell disease, usually those with HbSS or HbS-ß0 thal. These ulcers are the result of poor blood flow and usually develop following an injury to the skin. Leg ulcers are very difficult to treat, but many methods used to treat ulcers associated with other health conditions, such as diabetes, often are used to treat ulcers associated with sickle cell disease. In many cases, regular transfusions of red blood cells are given to increase the hemoglobin, dilute the sickle cells, and promote healing. It is important to pay special attention to any changes to or breaks in the skin before they become ulcers and to make your healthcare providers aware of any poorly healing wounds, especially on the legs. Pregnancy Considerations A woman with sickle cell disease can get pregnant. However, it is common for the disease and its complications to become more severe during pregnancy, as it is a stressful time for a woman’s body. There may be risks to the developing baby, as well. Pregnancy in a woman living with sickle cell disease is considered high risk and must be closely monitored by both a high-risk pregnancy specialist and a hematologist. hemoglobin) and high calorie needs may cause children with sickle cell disease to experience delayed growth. These children also may experience the changes of puberty at an older age than children who do not have sickle cell disease. Your child’s healthcare team will weigh and
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