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Episode 111: Sickle Cell Series - Acute Management of Sickle Cell Disease
The Fellow on Call: The Heme/Onc Podcast
Managing Acute Complications in Sickle Cell Disease
The connection between worsening pain crises in sickle cell disease and the development of acute chest syndrome involves mechanisms such as bone marrow infarct leading to fat microemboli in the lungs. These conditions can escalate rapidly, necessitating emergent care, including intubation and exchange transfusion, which can result in significant respiratory improvement. Post-discharge follow-ups can reveal recurring symptoms like severe back pain, dark urine, and signs of hemolysis, suggesting the possibility of delayed hemolytic transfusion reactions after exchange transfusions. This scenario emphasizes the complexities of managing acute complications in sickle cell patients, particularly during episodes of brisk hemolysis, and highlights the importance of prompt medical intervention and careful monitoring of hemoglobin levels and other symptoms.
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