Sickle cell crises

Crises are precipitated by various triggers, e.g. hypoxaemia (air travel, anaesthesia, etc.), infection, cold, dehydration and emotional stress.

Thrombotic crisis

Occurs most frequently in bones or joints but also affects chest and abdomen giving rise to severe pain. Neurological symptoms (e.g. seizures, focal signs), haematuria or priapism may be present. Pulmonary crises are the commonest reason for ICU admission; secondary chest infection or ARDS may supervene, worsening hypoxaemia and further exacerbating the crisis.

Aplastic crisis

Related to parvovirus infection, it is suggested by worsening anaemia and a reduction in the normally elevated reticulocyte count (10-20%).

Haemolytic crisis

Intravascular haemolysis with haemoglobinuria, jaundice and renal failure sometimes occurs.

Sequestration crisis

Rapid hepatic and splenic enlargement due to red cell trapping with severe anaemia. This condition is particularly serious.

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