Summary
Definition
History and exam
Key diagnostic factors
- pai(s) diagnosticado(s) com anemia falciforme, outra doença falciforme ou traço falciforme
- dor esquelética, torácica e/ou abdominal persistente
- dactilite
Other diagnostic factors
- temperatura elevada
- síndrome semelhante à pneumonia
- dor óssea
- moscas volantes
- taquipneia
- retardo do crescimento pôndero-estatural
- palidez
- icterícia
- taquicardia
- letargia
- hipertrofia do maxilar com sobremordida
- abdome protuberante, frequentemente com hérnia umbilical
- sopro cardíaco sistólico
- choque
Risk factors
- genética
Diagnostic tests
1st tests to order
- ensaios com base no ácido desoxirribonucleico (DNA)
- focalização isoelétrica da hemoglobina (IEF Hb)
- eletroforese de acetato de celulose
- cromatografia líquida de alta eficiência (HPLC)
- teste de solubilidade da hemoglobina
- esfregaço de sangue periférico
- hemograma completo e contagem de reticulócitos
- perfil de ferro
Tests to consider
- oximetria de pulso
- radiografia simples de ossos longos
- culturas bacterianas
- radiografia torácica
Emerging tests
- teste pré-natal não invasivo (TPNI)
Treatment algorithm
crise vaso-oclusiva
síndrome torácica aguda
doenças crônicas
Contributors
Authors
Sophie Lanzkron, MD, MHS
Director
Sickle Cell Center for Adults
Associate Professor of Medicine and Oncology
Johns Hopkins Medicine
Baltimore
MD
Disclosures
SL declares consultancy (Bluebird bio, Novo Nordisk, Pfizer, Novartis, Magenta); honoraria (Novartis); research funding (Imara, Novartis, GBT, Takeda, CSL-Behring, HRSA, PCORI, MD CHRC); stocks (Pfizer, Teva). SL is on the executive board of the National Alliance for Sickle Cell Centers (uncompensated).
Acknowledgements
Dr Sophie Lanzkron would like to gratefully acknowledge Dr Channing Paller, a previous contributor to this topic.
Disclosures
CP declares that she has no competing interests.
Peer reviewers
James Bradner, MD
Instructor in Medicine
Division of Hematologic Neoplasia
Dana-Farber Cancer Institute
Boston
MA
Disclosures
JB declares that he has no competing interests.
Adrian Stephens, MB BS, MD, FRCPath
Consultant Haematologist
University College London Hospitals
London
UK
Disclosures
AS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Bain BJ, Daniel Y, Henthorn J, et al. Significant haemoglobinopathies: a guideline for screening and diagnosis: a British Society for Haematology guideline. Br J Haematol. 2023 Jun;201(6):1047-65.Full text Abstract
National Heart, Lung, and Blood Institute. Evidence-based management of sickle cell disease: expert panel report, 2014. Sep 2014 [internet publication].Full text
DeBaun MR, Jordan LC, King AA, et al. American Society of Hematology 2020 guidelines for sickle cell disease: prevention, diagnosis, and treatment of cerebrovascular disease in children and adults. Blood Adv. 2020 Apr 28;4(8):1554-88.Full text Abstract
Chou ST, Alsawas M, Fasano RM, et al. American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support. Blood Adv. 2020 Jan 28;4(2):327-55.Full text Abstract
Trompeter S, Massey E, Robinson S, et al. Position paper on International Collaboration for Transfusion Medicine (ICTM) Guideline 'Red blood cell specifications for patients with hemoglobinopathies: a systematic review and guideline'. Br J Haematol. 2020 May;189(3):424-27.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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