Clinical presentation of severe anemia in pediatric patients with sickle cell anemia seen in Enugu, Nigeria

• Published in: American journal of hematology Vol. 72; no. 3; pp. 185 - 191
• Main Authors: Juwah, A.I., Nlemadim, A., Kaine, W.
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01-03-2003; Wiley-Liss
• Subjects: Adolescent; Anemia - diagnosis; Anemia - epidemiology; Anemia - etiology; Anemia, Sickle Cell - complications; Anemias. Hemoglobinopathies; Biological and medical sciences; Child; Child, Preschool; Diseases of red blood cells; Female; Fever; Hematologic and hematopoietic diseases; Hemoglobins - analysis; Humans; Infant; Jaundice; malaria; Malaria - complications; Male; Medical sciences; Nigeria; Osteomyelitis - complications; Pallor; Prospective Studies; Respiratory Tract Infections - complications; Respiratory Tract Infections - epidemiology; Sepsis - complications; severe anemia; sickle cell anemia; Tropical medicine; Urinary Tract Infections - complications; Nigeria; Africa; Human; Hemoglobinopathy; Protozoal disease; Sickle cell anemia; Malaria; severe anemia; Hemopathy; Parasitosis; Epidemiology; Genetic disease; Infection; Symptomatology; Hemolytic anemia; Severe; Nigeria; Child
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.10285

Anemia is a major cause of morbidity and mortality among patients with sickle cell anemia. In this study, 108 episodes of severe anemia were prospectively evaluated in 108 patients with hemoglobin SS disease attending the pediatric sickle cell clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria. Young children between the ages of 2 and 4 years were found to be at the greatest risk of developing anemic crises (severe anemia). There was a gradual but progressive decline in the incidence of severe anemia in the age range 8–16 years old. Upper respiratory tract infections are the most commonly associated infections in patients with severe anemia. Others included malaria, septicemia, urinary tract infection, acute chest syndrome, and osteomyelitis. Their role in precipitating episodes of severe anemia among the patients studied could not be fully evaluated. Pallor, jaundice, and fever were the most commonly encountered symptoms in patients with severe anemia on admission. About half of the parents/guardians failed to notice severe anemia among the patients studied, perhaps due to the dark color of the African skin. Caregivers need to be educated on how to recognize anemia among patients with sickle cell anemia when they develop febrile episodes. Am. J. Hematol. 72:185–191, 2003. © 2003 Wiley‐Liss, Inc.