Sickle Cell Anemia Research Today is a free monthly online journal that collates and summarizes the latest research about Sickle Cell Anemia, including details on genetics, causes, symptoms.

Skull bone infarctive crisis and deep vein thrombosis in homozygous sickle cell disease- case report and review of the literature.

Alli NA, Wainwright RD, Mackinnon D, Poyiadjis S, Naidu G

Department of Haematology, National Health Laboratory Service & University of Witwatersrand, Johannesburg, South Africa.

Here we describe an 8-year old male child with homozygous sickle cell disease who presented with left parietal skull bone infarction and, during his stay in hospital, developed a right femoral deep vein thrombosis (DVT), both uncommon complications of the disease. He initially presented with severe headache and generalised tenderness of the calvarium, which did not respond to simple analgesics. Scalp swelling in and around the left frontal (including left orbit) and parietal regions developed 24 h after presentation. The differential diagnosis included incipient stroke, acute sickle bone crisis and osteomyelitis, with a possible complication of epidural haematoma, or orbital compression syndrome. An initial exchange blood transfusion did not lead to appreciable reduction in opiate requirements. Significant symptomatic relief was attained only after a second exchange transfusion. The DVT developed at the site of catheterisation (right femoral vein), and this was treated with maximal doses of enoxaparin followed by warfarin. The child is now well and off anti-coagulants. In this article we present a review of the literature and discuss possible mechanisms of these complications in our patient.

Published 24 April 2007 in Hematology, 12(2): 169-74.
Full-text of this article is available online (may require subscription).

© 2006-2008 Sickle Cell Anemia Research Today. All Rights Reserved.