Analysis of 16 teenage patients with sickle cell anemia and musculoskeletal complications

Abstract

Background Sickle cell anemia is a genetic hematological disorder characterized by red blood cell abnormality including rigidity and sickling. Once a sufficient number of rigid sickle cells have formed, microvascular occlusion will result, which leads to tissue ischemia and infarction and progressive end-organ damage. Aim The aim of this study was to determine the pattern of musculoskeletal complications in 16 teenage patients with sickle cell disease over a period of 2 years. Patients and methods This is a retrospective study of cases of musculoskeletal complications among sickle cell anemic patients over a period of 2 years, referred to the Rheumatologic Clinic of Mazandaran University of Medical Sciences from January 2010 to December 2012. Data were analyzed using SPSS, version 20. Variables analyzed included age, sex, and type of musculoskeletal complication. Results There were 16 sickle cell patients referred to our Rheumatologic Clinic for musculoskeletal complications. All patients were teenagers aged between 12 and 17 years, with a median age of 14.6 years. There were 12 male and four female patients. The most common musculoskeletal complication was acute painful crisis in 10 (62.5%) patients, osteomyelitis in three (18.5%), dactylitis in four (25%), avascular necrosis of bones in six (37.5%), stress fractures and vertebral collapse in two (12.5%), septic arthritis in one (0.6%), and hyperuricemia/gout arthritis in three (18.5%) patients. Conclusion Serious musculoskeletal complications of sickle cell anemia are very important and must be considered in these patients. Painful crisis and avascular necrosis of bones are common rheumatologic complications of this disorder.