Hemoglobin sickle cell disease complications: a clinical study of 179 cases.

Abstract:

BACKGROUND:Hemoglobin sickle cell disease is one of the most frequent hemoglobinopathies. Surprisingly, few studies have been dedicated to this disease, currently considered to be a mild variant of homozygous sickle cell disease. The aim of this study was to update our knowledge about hemoglobin sickle cell disease. DESIGN AND METHODS:The study involved a single center series of 179 patients. Clinical and biological data were collected with special attention to the assessment of pulmonary arterial hypertension and nephropathy. RESULTS:Hemoglobin sickle cell diagnosis was delayed and performed in adulthood in 29% of cases. Prevalence of hospitalized painful vasoocclusive crisis, acute chest syndrome and priapism was 36%, 20% and 20%, respectively. The most common chronic organ complications were retinopathy and sensorineural otological disorders in 70% and 29% of cases. Indeed, prevalence of complications reported in homozygous sickle cell disease, such as nephropathy, suspicion of pulmonary hypertension, strokes and leg ulcers was rather low (13%, 4% and 1%, respectively). Phlebotomy performed in 36% of this population (baseline hemoglobin 11.5 g/dL) prevented recurrence of acute events in 71% of cases. CONCLUSIONS:Our data suggest that hemoglobin sickle cell disease should not be considered as a mild form of sickle cell anemia but as a separate disease with a special emphasis on viscosity-associated otological and ophthalmological disorders, and with a low prevalence of vasculopathy (strokes, pulmonary hypertension, ulcers and nephropathy). Phlebotomy was useful in reducing acute events and a wider use of this procedure should be further investigated.

journal_name

Haematologica

journal_title

Haematologica

authors

Lionnet F,Hammoudi N,Stojanovic KS,Avellino V,Grateau G,Girot R,Haymann JP

doi

10.3324/haematol.2011.055202

subject

Has Abstract

pub_date

2012-08-01 00:00:00

pages

1136-41

issue

8

eissn

0390-6078

issn

1592-8721

pii

haematol.2011.055202

journal_volume

97

pub_type

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