Document Detail


Types of anaemic crises in paediatric patients with sickle cell anaemia seen in Enugu, Nigeria.
MedLine Citation:
PMID:  15155406     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Anaemic crises in paediatric patients with sickle cell anaemia are major causes of morbidity and mortality. Some children admitted to hospitals' emergency rooms or paediatric wards of the hospitals with severe anaemia die before blood transfusion. AIMS AND METHODS: A total of 108 episodes of anaemic crises were prospectively evaluated in 108 patients with sickle cell anaemia attending the paediatric sickle cell clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria. RESULTS: Hyper-haemolytic crises were the commonest types of anaemic crises in the patients studied. The mean haemoglobin concentration of 44.66 (SD 6.42) g/l in crises was significantly lower than the mean steady state level of 78.69 (SD 8.50) g/l. Reticulocytes, unconjugated serum bilirubin concentrations, and the presence of nucleated red blood cells were also increased. About 4.6% of patients were not jaundiced at presentation even though they were profoundly anaemic. Their haematological indices gradually returned to normal without marked changes in their serum bilirubin concentrations. These patients were probably in the early recovery phase of aplastic crises. The classical presentation of acute splenic sequestration crisis with a rapidly enlarging spleen and hypotension was not observed. This was probably because of its precipitate nature and accompanying circulatory collapse, which carried a high mortality rate. Minor forms of sequestration crises may have occurred in the liver and spleen. CONCLUSIONS: Malaria appeared to have played a role in precipitating some of the hyper-haemolytic episodes. Further studies to elucidate this role are required so that appropriate recommendations regarding malaria prophylaxis can be made in patients with sickle cell anaemia.
Authors:
A I Juwah; E U Nlemadim; W Kaine
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of disease in childhood     Volume:  89     ISSN:  1468-2044     ISO Abbreviation:  Arch. Dis. Child.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-05-24     Completed Date:  2004-06-15     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372434     Medline TA:  Arch Dis Child     Country:  England    
Other Details:
Languages:  eng     Pagination:  572-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria. anthonyjuwah@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anemia, Sickle Cell / blood,  complications*,  therapy
Antimalarials / administration & dosage
Bilirubin / blood
Child
Child, Preschool
Chloroquine / administration & dosage
Female
Hemoglobins / analysis
Humans
Jaundice / complications
Malaria / complications
Male
Nigeria
Prospective Studies
Reticulocyte Count
Chemical
Reg. No./Substance:
0/Antimalarials; 0/Hemoglobins; 54-05-7/Chloroquine; 635-65-4/Bilirubin
Comments/Corrections

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