Background: Adults with sickle cell disease (SCD) often present with extremely painful acute vaso-occlusive crises (VOC). VOC guidelines encourage early initiation of opioids, but are lacking in a standardized approach to achieve adequate analgesia and subsequent de-escalation. Various SCD studies comparing continuous basal versus demand bolus patient-controlled analgesia (PCA) show conflicting outcomes. Thus the objective […]

Case Presentation: A 29 year-old woman with sickle cell disease (SCD) on hydroxyurea and L-glutamine, and mild intermittent asthma presented to our institution with right lower extremity and back pain suggestive of a vaso-occlusive crisis. She did not report fever, cough or dyspnea. Vital signs revealed a heart rate of 91/min, blood pressure of 126/86 […]

Case Presentation: A 17yo female with sickle cell disease (SCD; HbSS genotype) presented with pain crisis and acute chest syndrome. She was treated with appropriate antibiotics (ceftriaxone/cefdinir and azithromycin). During the first few days of her hospitalization, she required 2 pRBC transfusions for down trending hemoglobin (Hb) and low reticulocyte count. On hospital day 11, […]