How I diagnose and treat venous thromboembolism in sickle cell disease.

Abstract:

:The incidence of venous thromboembolism (VTE) in adult patients with sickle cell disease (SCD) is high. However, overlapping features between the clinical presentation of VTE and SCD complications and a low index of suspicion for thrombosis can influence patient management decisions. VTE in SCD can therefore present management challenges to the clinical hematologist. Herein, we present 3 distinct clinical vignettes that are representative of our clinical practice with SCD patients. These vignettes are discussed with specific reference to the hypercoagulable state in SCD patients, recent VTE diagnosis and anticoagulant therapy guidelines from the general population, and evaluation of the risk of bleeding as a result of long-term exposure to anticoagulant therapy. We examine current diagnostic and treatment options, highlight limitations of the existing clinical prognostic models that offer personalized guidance regarding the duration of anticoagulation, and propose a clinical approach to guide the decision to extend anticoagulation beyond 3 months.

journal_name

Blood

journal_title

Blood

authors

Shet AS,Wun T

doi

10.1182/blood-2018-03-822593

subject

Has Abstract

pub_date

2018-10-25 00:00:00

pages

1761-1769

issue

17

eissn

0006-4971

issn

1528-0020

pii

blood-2018-03-822593

journal_volume

132

pub_type

杂志文章,评审

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