Anaemic Crises in Patients with Sickle-cell Anaemia

Abstract

Summary:  In order to determine the relative frequencies of the different causes of severe anaemia among patients with sickle cell anaemia (SCA), 104 con secutive patients with SCA presenting over an eight-month period with severe anaemia (PCV 15 percent) were studied at the children's emergency ward, University College Hospital, Ibadan. They accounted for 8.2 percent of all admissions and 24.2 percent of those who had severe anaemia. Among the patients with SCA, hyperhaemolytic, acute splenic sequestration and aplastic crises constituted 49,20 and 12.5 percent of the anaemic crises, respectively. Ten patients (9.6 percent) showed mixed features and could not be definitely classified. The frequency rate of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency was similar between patients with hyperhaemolytic and those with other forms of anaemic crisis, a finding which suggests that G 6-PD deficiency neither aggravates nor ameliorates haemolysis in SCA. The mortality in the series was 8.7 percent. Six of the patients who died had hyperhaemolysis while the other three had acute splenic sequestration crisis. Five of these deaths occurred despite emergency blood transfusion.