SHM Converge Scientific Abstract ePoster Gallery-Iron Deficiency Anemia and Cerebral Venous Thrombosis in 21-Month Old

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This case describes a 21-month-old girl who presented to the emergency department with sudden, severe right-sided weakness and inability to stand. On examination, she was pale. Laboratory testing showed profound iron deficiency anemia with hemoglobin 3.5 g/dL, microcytosis (MCV 49 fL), low serum iron, and very low iron saturation.<br /><br />She received three units of packed red blood cells. Brain CT and MRI/MRV showed venous flow abnormalities and cortical vein thrombosis involving the superior sagittal, left transverse, and left sigmoid sinuses. She was started on enoxaparin and iron supplementation and discharged with neurology and hematology follow-up.<br /><br />Six days later, she was readmitted because of right arm stiffness. EEG demonstrated epileptiform activity, and she was discharged on levetiracetam.<br /><br />The report emphasizes that cerebral venous thrombosis should be considered in children who present with focal neurologic deficits in the setting of severe anemia. Treating both the anemia and the thrombosis can lead to symptom improvement. Clinicians should also be aware that seizures may develop in these patients.<br /><br />The discussion notes that iron deficiency anemia has been associated with both arterial and venous thrombosis. Proposed mechanisms include reactive thrombocytosis, increased blood viscosity, and altered cerebral metabolic demands.

Asset Subtitle

Michelle Omega

Meta Tag

Author List Kelly Staples, Michelle Omega, Neil Zhao, Valien Kondos

Category Clinical Vignettes

Concept Iron Deficiency Anemia

Concept Cerebral Venous Thrombosis

Concept Anticoagulation

Concept Focal Neurologic Deficit

Concept Severe Anemia

Distinguished Non-Finalist

Presenter Organization Sidney Kimmel Medical College

Presenting Author Michelle Omega

Track Pediatric

Keywords

iron deficiency anemia

cerebral venous thrombosis

pediatric stroke

focal neurologic deficit

microcytic anemia

cortical vein thrombosis

superior sagittal sinus

enoxaparin

seizure

levetiracetam

Iron Deficiency Anemia

Cerebral Venous Thrombosis

Anticoagulation

Focal Neurologic Deficit

Severe Anemia