Cocaine abuse complicating acute painful episodes in sickle cell disease.

We report three sickle cell patients with recent cocaine abuse who presented with typical symptoms of vaso-occlusion rapidly progressing to major organ dysfunction. Our experience suggests cocaine abuse is a risk factor for major complications of a sickle cell painful episode. Enhanced clinical and laboratory surveillance for organ dysfunction is indicated if a history of cocaine abuse is elicited. Evidence of organ failure should lead to consideration of early aggressive interventions such as transfusion therapy.