Infections : increased

risk
especially
to
encapsulated
bacteria
because
of
autosplenectomy.
Hepatobiliary
complications:
Pigemented gallstones
due
to
increased
bilirubin from hemolysis.
Biliary sludge
Biliary cholic
Acute cholecystitis
Acute choledocolithiasis
Acute cholangitis
Acute
hepatic
sequestration
Acute
intrahepatic
cholestasis
Pain
from
vasoocclusion

Acute
chest
syndrome :
Presents with signs and
sx of lower resp tract
infection and has a new
pulmonary infiltrate on
radiograph .

Workup: CBC with diff.

blood and urine cx.
-if SOB, cough,
tachypnea, investigate
for acute chest
syndrome
Workup: LFTS, CBC with
retic, RUQ sono.

Splenic

-Hospitalize if high fever

and give abx therapy
Tx:
-surgery cholecystitis
-ERCP for cholangitis
-Exchnage transfusion
for Acute hepatic
sequestration and acute
intrahepatic cholestasis

Presents as acute onset

of pain in chest, back,
extremities. Triggers
stress, cold, and
infections

Dx: Xray , O2 sats

-CBC with diff and retic.
-blood cx.

-can develop sudden or

slow.
-#1 cause of death in
adult
Priapism: 1/3rd of men

Prevention:
Immunizations and ppx
antibotics until 5 years
old.

Treat mild pain with

NSAIDS If they tolerate
it. Narcotics for severe
pain.
*should also rule out
acute chest syndrome
and osteomyelitis.
(xray MRI)
Tx: Abx IV cephalosporin
and oral macrolide.
-Keep O2 sats > 95%
-give transfusion only if
rapid deteriorating or
the Hg has dropped
more than 1 unit from
baseline.
-Encourage incentive
spirometry

Need prompt treatment

because can cause
permanent erectile
dysfunction.
Elevated retic,

Tx: vigorous hydration

and analgesics.
-only transfuse if
surgery is required.
Tx:

sequestration:

nucleated RBCs and

decreased platelet.

Sudden drop 2 units Hg

from
baseline
and
enlargement of spleen.

Stroke:
-Kids ischemic stroke
-Adults
hemorrhagic
stroke
Multisystem
organ
failure.

Workup: CT

Comprehensive
metabolic panel . CBC
with diff.

1) splenic sequestration
with hypovolemia:
Immediate IV hydration
2) Splenic sequestration
with severe anemia.
Transfuse to raise Hg
but slowly because can
cause over transfusion
Tx: exchange
transfusion.

Tx: exchange
transfusion.

Presents
are
rapid
deterioration,
fever,
drop
in
Hg,
and
encephalopathy

42 years for males and 48 years for females.

Among those with sickle cell-hemoglobin C disease, the
median age at death was 60 years for males and 68 years
for females