Sickle Cell Anemia(Sickle Cell Disease)
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Editorial Staff and Contributors DefinitionSickle cell anemia is a blood disorder that changes the shape of some red blood cells (RBCs). The new, sickle shape makes it difficult for RBCs to carry oxygen. The odd shape can also cause acute episodes of pain known as sickle cell crisis. The body will also destroy these sickle red blood cells because they are abnormal. Destroying sickle cells decreases the overall number of RBCs and can lead to anemia. The change in the ability and number of RBCs can both decrease the amount of oxygen for the body.
Causes TOPSickle cell disease is a genetic disorder. If you receive 1 defective gene from each of your parents, then you will have sickle cell disease. If you only have 1 defective gene, you are said to have sickle cell trait, but not sickle cell disease. Although you won’t usually have any symptoms, you can pass this gene on to your children. Risk Factors TOPSickle cell disease is more common in people who are black or of sub-Saharan origin. It is also more common in people of Greek and Italian descent as well as in people from some parts of India, Central and South America, and the Arabian Peninsula. Symptoms TOPThis condition produces a group of symptoms known as a sickle cell crisis. These are episodes of pain that occur with varying frequency and severity. It is usually followed by periods of remission. The risk for a sickle cell crisis increases with any activity that boosts the body's requirement for oxygen such as: This may include
Sickle cell crises can last hours or days. They affect the bones of the back, the long bones, and the chest. Crises can be severe enough to require hospital admission for pain control and IV fluids. Symptoms of sickle cell crisis include:
Complications of sickle cell anemia include:
Diagnosis TOPSickle cell anemia is diagnosed with a specific blood test. Hemoglobin electrophoresis is a simple blood test. It can be done by most laboratories or a local sickle cell foundation. Most states require testing of newborns for sickle cell. Amniocentesis is a form of prenatal testing. It can also detect sickle cell disease. Treatment TOPSickle cell cannot be cured. Basic treatment of sickle cell crisis includes:
In addition, treatment may include: PenicillinNewborns with sickle cell disease may be given penicillin . It is given twice a day, beginning at age 2 months. It is continued until at least 5 years of age. Pneumococcal VaccineIt is recommended that children with sickle cell disease receive pneumococcal vaccine (PCV-13) series. Other routine immunizations should also be given, such as an annual flu shot. Hydroxyurea (Hydrea) TOPHydroxyurea is the first drug to significantly prevent complications of sickle cell disease. It increases the production of fetal hemoglobin which decreases the number of deformed RBCs. This treatment can reduce the frequency of sickle cell crisis. However, hydroxyurea is not appropriate for everyone with sickle cell disease. Blood Transfusions TOPBlood transfusions can treat and prevent some of the complications. The transfusion introduces health red blood cells. Transfusion therapy can help prevent recurring strokes in children. Bone Marrow Transplant TOPA bone marrow transplant from a matched donor may be effective. There are medical risks involved. Recipients must also take drugs that suppress the immune system for the rest of their lives. Prevention TOPSickle cell anemia cannot be prevented. There are some general guidelines that may keep the condition under control. Be sure to discuss these with your doctor:
RESOURCES:American Sickle Cell Anemia Association http://www.ascaa.org Sickle Cell Information Center http://scinfo.org CANADIAN RESOURCES:About Kids Health—The Hospital for Sick Children http://www.aboutkidshealth.ca Sickle Cell Foundation of Alberta http://www.sicklecellfoundationofalberta.org References:
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Last reviewed November 2017 by Michael J. Fucci, DO Last Updated: 11/14/2017 |
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