title: Current management of sickle cell anemia.
abstract: Proper management of sickle cell anemia (SCA) begins with establishing the correct diagnosis early in life, ideally during the newborn period. The identification of affected infants by neonatal screening programs allows early initiation of prophylactic penicillin and pneumococcal immunizations, which help prevent overwhelming sepsis. Ongoing education of families promotes the early recognition of disease-released complications, which allows prompt and appropriate medical evaluation and therapeutic intervention. Periodic evaluation by trained specialists helps provide comprehensive care, including transcranial Doppler examinations to identify children at risk for primary stroke, plus assessments for other parenchymal organ damage as patients become teens and adults. Treatment approaches that previously highlighted acute vaso-occlusive events are now evolving to the concept of preventive therapy. Liberalized use of blood transfusions and early consideration of hydroxyurea treatment represent a new treatment paradigm for SCA management.
authors.affiliation: Texas Children's Center for Global Health, Houston, Texas 77030, USA.
authors.forename: Patrick T
authors.initials: PT
authors.lastname: McGann
authors.forename: Alecia C
authors.initials: AC
authors.lastname: Nero
authors.forename: Russell E
authors.initials: RE
authors.lastname: Ware
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000628:therapy; D000986:Antisickling Agents / Q000627:therapeutic use*; D002648:Child; D002986:Clinical Trials as Topic; D042241:Early Diagnosis; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use*; D007231:Infant, Newborn; D015997:Neonatal Screening; D010353:Patient Education as Topic; D010406:Penicillins / Q000627:therapeutic use*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000986:Antisickling Agents; D010406:Penicillins; D022242:Pneumococcal Vaccines; D006918:Hydroxyurea