title: Emergency Medicine Management of Sickle Cell Disease Complications: An Evidence-Based Update.
abstract: BACKGROUND
  Sickle cell disease (SCD) affects approximately 100,000 individuals in the United States. Due to alterations in the structural conformation of hemoglobin molecules under deoxygenated conditions, patients with SCD are predisposed to numerous sequelae, many of which require acute intervention.
  
  
  OBJECTIVE
  Our aim was to provide emergency physicians with an evidence-based update regarding the diagnosis and management of SCD complications.
  
  
  CONCLUSIONS
  SCD patients experience significant morbidity and mortality secondary to cerebrovascular accident, acute chest syndrome, acute vaso-occlusive pain crises, SCD-related multi-organ failure, cholecystitis, acute intrahepatic cholestasis, acute sickle hepatic crisis, acute hepatic sequestration, priapism, and renal disease. Emergency physicians must recognize acute manifestations of SCD in order to deliver timely management and determine patient disposition.
  
  
  CONCLUSIONS
  A comprehensive review of the emergency department management of acute SCD complications is provided. Comprehensive understanding of these aspects of SCD can assist physicians in expediting patient evaluation and treatment, thus decreasing the morbidity and mortality associated with this hemoglobinopathy.
authors.affiliation: Department of Emergency Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas.
authors.forename: Erica
authors.initials: E
authors.lastname: Simon
authors.affiliation: Department of Emergency Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas.
authors.forename: Brit
authors.initials: B
authors.lastname: Long
authors.affiliation: Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Alex
authors.initials: A
authors.lastname: Koyfman
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology; D056586:Acute Chest Syndrome / Q000175:diagnosis / Q000209:etiology; D059787:Acute Pain / Q000188:drug therapy* / Q000209:etiology; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000628:therapy; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D004635:Emergency Medicine / Q000379:methods*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000382:microbiology; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D017410:Practice Guidelines as Topic; D011317:Priapism / Q000209:etiology / Q000628:therapy; D065227:Transfusion Reaction
keywords: acute chest; acute pain crisis; cerebrovascular accident; sickle cell disease; transfusion