Bone marrow necrosis - initial presentation in sickle cell anemia.

PATIENT

Male, 20 FINAL DIAGNOSIS: Sickle cell anemia Symptoms: Bone marrow necrosis • bone pain • fever • hepatomegaly • icterus • splenomegaly • weakness

MEDICATION

• 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.

CASE REPORT

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.