title: Bone marrow necrosis - initial presentation in sickle cell anemia.
abstract: METHODS
  Male, 20 FINAL DIAGNOSIS: Sickle cell anemia Symptoms: Bone marrow necrosis • bone pain • fever • hepatomegaly • icterus • splenomegaly • weakness
  
  
  METHODS
  - Clinical Procedure: - Specialty: Hematology.
  
  
  OBJECTIVE
  Unusual clinical course.
  
  
  BACKGROUND
  In sickle cell disease, bone involvement is the commonest clinical presentation in the acute as well as chronic setting presenting as painful vaso-occlusive crisis and avascular necrosis, respectively. Other complications include bone marrow necrosis and infarction.
  
  
  METHODS
  We report a case of a 20-year-old male who was referred for bone marrow evaluation due to symptoms of fever, weakness, and repeated episodes of bone pains. Bone trephine biopsy revealed multiple areas of central necrosis surrounded by fibroblasts.
  
  
  CONCLUSIONS
  Recognition of necrosis through bone trephine biopsy is important for early initiation of therapy.
authors.affiliation: Department of Pathology and Microbiology, Aga Khan University and Hospital, Karachi, Pakistan.
authors.forename: Maria
authors.initials: M
authors.lastname: Shafiq
authors.forename: Natasha
authors.initials: N
authors.lastname: Ali
keywords: bone marrow; necrosis; sickle cell