Hematology and Oncology Book

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Acute Vaso-Occlusive Episode in Sickle Cell AnemiaAka: Sickle Cell Crisis

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  1. See Also
    1. Sickle Cell Anemia
  2. Precipitating Factors
    1. Preceded by infection 25% of the time
      1. Human Parvovirus B19 is a common viral cause
    2. Cold Weather due to reflex vasospasm
    3. Dehydration in warm weather
  3. Symptoms
    1. Child under age 18 years
    2. Recurrent painful crises
    3. Sudden onset pain in abdomen, chest, back and joints
  4. Labs
    1. Profound Anemia
    2. Reticulocyte Count <1%
  5. Management
    1. Pain control for acute crisis
      1. Requires aggressive Narcotic Analgesia
      2. Consider Patient Controlled Analgesia (PCA Pump)
      3. Morphine is preferred over Meperidine (Seizure risk)
    2. Intravenous fluids
      1. Avoid Fluid Overload
      2. Limit total fluid to <1.5x maintenance requirements
    3. Oxygen if Hypoxia present
    4. Incentive Spirometry
  6. Course
    1. Acute Crisis usually resolves spontaneously 7-10 days
  7. References
    1. Preboth (2000) Am Fam Physician :

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