Sickle Cell Anemia

Sickle cell anemia:  A congenital hemolytic anemia that occurs primarily but not exclusively in black people,
sickle cell anemia results from a defective hemoglobin molecule ( hemoglobin
S ) that causes RBC’s ( red blood count ) to roughen and become sickle
shape. These cells impair circulation, resulting in chronic ill health,
periodic crises, long term complications, and premature death.

This inherited disease involves an abnormality of hemoglobin, the component
of red blood cells that carries oxygen.  The normal hemoglobin molecule
is of the A type.  In sickle cell disease much of the hemoglobin is
of the type called S type, giving it it’s shape.  Unlike normal, flexible
red cells, the sickled cells are stiff; groups of them may become entangled
in such a way as to obstruct smaller blood vessels.  When obstruction
occurs there is severe joint swelling and pain, more common in the fingers,
and toes, a development often referred to as sickle cell crisis. 
There may also be paralysis and convulsions resulting from cerebral thrombosis.

Symptoms: 

Joint swelling

Pain

Jaundice

Pallor

Chest pains

Aching bones

Ischemic leg ulcer ( especially around the ankles )

Increase susceptibility to infection

Paralysis

Convulsions

Tachycardia ( rapid heart rate )

Cardiomegaly ( enlarge heart )

Systolic and diastolic murmurs

Chronic fatigue

Unexplained dyspnea ( difficulty breathin/labored )

Hepatomegaly ( enlarge liver )

Splenomegaly ( enlarge spleen )

Patient with painful vaso – occlusive crisis may manifest severe abdominal,
thoracic, muscular, or bone pain; possible increased jaundice and dark
urine; low grade fever; and, in long term disease, spleen shrinkage.

Treatment:

Therapy for this anemia is primarily symptomatic and can usually be
done at home.  Hemoglobin level should be check frequently, if hemoglobin
drops suddenly or if the patient condition deteriorates rapidly, he must
be hospitalized for possible transfusion of packed RBCs.  In a sequestration
crisis, treatment may include sedation and administration of analgesics,
blood transfusion, oxygen administration, and administration of large amounts
of oral or I.V. fluids

 * Watch for signs of sickle cell crises:  includes; pale
lips, tongue, palms, or nail beds; lethargy; listlessness; sleepiness,
with difficulty awakening; irritability; severe pain temperature over 104
degree C or fever of 100 degree that persist for 2 days.

** CALL YOUR DOCTOR PROMPTLY if you experience the above symptoms.