Complications
Sickle-cell anaemia can lead to various complications, including:
* Overwhelming post-(auto)splenectomy infection (OPSI), which is due to functional asplenia, caused by encapsulated organisms such as Streptococcus pneumoniae and Haemophilus influenzae. Daily penicillin prophylaxis is the most commonly used treatment during childhood, with some haematologists continuing treatment indefinitely. Patients benefit today from routine vaccination for H. influenzae, S. pneumoniae, and Neisseria meningitidis.
* Stroke, which can result from a progressive vascular narrowing of blood vessels, preventing oxygen from reaching the brain. Cerebral infarction occurs in children, and cerebral hemorrhage in adults.
* Cholelithiasis (gallstones) and cholecystitis, which may result from excessive bilirubin production and precipitation due to prolonged haemolysis.
* Jaundice, yellowing of the skin, may occur due to the inability of the liver to effectively remove bilirubin from the filtering of damaged red blood cells out of the blood supply as well as blocks in the organ's blood supply.[10][11]
* Avascular necrosis (aseptic bone necrosis) of the hip and other major joints, which may occur as a result of ischemia.
* Decreased immune reactions due to hyposplenism (malfunctioning of the spleen).
* Priapism and infarction of the penis.
* Osteomyelitis (bacterial bone infection), Salmonella is the second most common organism behind Staphylococcus Aureus which remains first in both the general population and those with sickle cell. organism.[12]
* Opioid tolerance, which can occur as a normal, physiologic response to the therapeutic use of opiates. Addiction to opiates occurs no more commonly among individuals with sickle-cell disease than among other individuals treated with opiates for other reasons.
* Acute papillary necrosis in the kidneys.
* Leg ulcers.
* In eyes, background retinopathy, proliferative retinopathy, vitreous haemorrhages and retinal detachments, resulting in blindness. Regular annual eye checks are recommended.
* During pregnancy, intrauterine growth retardation, spontaneous abortion, and pre-eclampsia.
* Chronic pain: Even in the absence of acute vaso-occlusive pain, many patients have chronic pain that is not reported[13].
* Pulmonary hypertension (increased pressure on the pulmonary artery), leading to strain on the right ventricle and a risk of heart failure; typical symptoms are shortness of breath, decreased exercise tolerance and episodes of syncope[14].
* Chronic renal failure—manifests itself with hypertension (high blood pressure), proteinuria (protein loss in the urine), hematuria (loss of red blood cells in urine) and worsened anaemia. If it progresses to end-stage renal failure, it carries a poor prognosis.[15]
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