Acute myocardial infarction in sickle cell disease: a possible complication of hydroxyurea treatment.
We describe a 28-year-old man treated with hydroxyurea for sickle cell anemia, who was admitted to the University Hospital with an acute myocardial infarction. The patient had evolved high hematocrit values during his long-term hydroxyurea treatment, suggesting a correlation between a possible increment in blood viscosity and the coronary occlusion without previous lesions. Indeed, several studies associate vasocclusive episodes and severe clinical course with high viscosity. Although hydroxyurea is considered an effective therapeutic option for these patients, care should be taken to monitor hematocrit levels and possible complications. Hematocrit and hemoglobin values of above 30% and 10.5 g/dl in SS patients on hydroxyurea therapy should be avoided or closely monitored.
Fattori
André
A
Hemocentro da UNICAMP, Campinas, Brazil. afattori@unicamp.br
de Souza
Robenílson Almeida
RA
Saad
Sara Terezinha Olalla
ST
Costa
Fernando Ferreira
FF
D000328:Adult; D000755:Anemia, Sickle Cell / Q000188:drug therapy*; D000986:Antisickling Agents / Q000009:adverse effects; D001809:Blood Viscosity; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006918:Hydroxyurea / Q000009:adverse effects*; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000139:chemically induced*
D000986:Antisickling Agents; D006454:Hemoglobins; D006918:Hydroxyurea