Reverse sequestration in a case of sickle crisis.
A patient with homozygous sickle cell disease presented with sickle crisis complicated by hepatic and pulmonary sequestration and required intensive therapy. During the recovery phrase she developed a rapid rise of haemoglobin concentration, unrelated to blood transfusion, followed by hypertension, congestive cardiac failure and catastrophic intracerebral haemorrhage. This serious haemodynamic disturbance was considered to be caused by a reversal of the sequestration process. Careful monitoring of a sickle cell patient's blood pressure, blood counts, haematocrits, haemoglobin S level and plasma viscosity, even after the end of a sequestration crisis, is recommended.
Lee
E S
ES
University Department of Haematology, Royal Liverpool University Hospital, UK.
Chu
P C
PC
D000328:Adult; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D002543:Cerebral Hemorrhage / Q000150:complications; D017809:Fatal Outcome; D005260:Female; D006333:Heart Failure / Q000150:complications; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000150:complications; D008099:Liver / Q000503:physiopathology*; D008168:Lung / Q000503:physiopathology*
D006454:Hemoglobins