1: Haematology - Sickle Cell Disease Flashcards
What is sickle cell disease
Autosomal recessive haemaglobinotpathy where individuals have HbSS
What is sickle cell trait
HbSA
What ethnicities is sickle cell more common
African-American
East- Medeteranian
What is the inheritance pattern of sickle cell
Autosomal Recessive
What causes sickle cell anaemia
Mutation in position-6, chromosome 11. Where valine replaces glutamic acid
What chromosome is affected in sickle cell anaemia
Chromosome 11
What amino acid is mutated in sickle cell anaemia
Valine replaces Glutamic acid
What kind of mutation happens in sickle cell
Non-conservative mis-sense mutation
What is a risk factor for sickle cell disease
FH
Explain advantage of sickle cell disease and trait
Sickle cell trait is advantageous against Malaria Falciparum
Explain presentation of sickle-cell
Sickle cell is characterised by period of good health with intervening crisis
What is vase-occlusive crisis also known as
Pain crisis
In which age group does vase-occlusive crisis usually present
Childhood
Adolescence
Explain presentation of vase-occlusive crisis in children
Presents with dactylitis and bone pain
What happens with vaso-occlusive crisis
Becomes more central with age can lead to acute chest syndrome and stroke
What is acute chest syndrome is type of
Vaso-occlsuive crisis
What are 3 triggers of vase-occlusive crisis
Dehydration
Infection
Deoxygenation
What is acute chest syndrome
When there is vaso-occlusion of pulmonary vasculature
How does acute chest syndrome present
- Chest pain
- Breathlessness
- Reduced SpO2
- Fever
- Respiratory distress
What is the most common cause of death in sickle cell disease
Acute chest syndrome
What are 3 triggers of acute chest syndrome
GA
Asthma
Infection
What is splenic sequestration
Vaso-occlusion of spleen causes entrapment of blood and pooling of large amounts of blood in the spleen
In which age is splenic sequestration more common
First year of life
How does splenic sequestration present clinically
- LUQ pain
- Symptoms intravascular haemolysis: hypotension
- Rapid anaemia
- Reticulocytosis
Aside from splenic sequestration, what other organs may be affected
Later liver and lung
What can splenic sequestration cause over time and what does this mean
Autosplenectomy: causes fibrosis of the spleen and necrosis. This means spleen cannot function predisposing to infection with capsulated bacteria
What are some capsulated bacteria
H. Influenza
S. Pneumonia
N. Meningitdis
What is an aplastic crisis
Sickle cell patient is infected with parvovirus B19