Darbari Deepika S, Ballas Samir K, Clauw Daniel J
Division of Hematology, Department of Pediatrics, Center for Cancer and Blood Disorders, Children's National Medical Center, George Washington University, Washington, DC, USA.
Eur J Haematol. 2014 Aug;93(2):89-95. doi: 10.1111/ejh.12340. Epub 2014 May 16.
Painful vaso-occlusive crises (VOCs) are the hallmark of sickle cell disease (SCD); however, many patients experience frequent daily pain that does not follow the pattern of typical VOCs. This pain of variable severity, also referred as persistent pain in the SCD literature, contributes to significant morbidity and poor quality of life and often fails to respond adequately to standard SCD therapies. In this article, we briefly describe types of pain encountered in SCD with a special emphasis on persistent pain. We discuss altered pain processing as a potential contributing mechanism, which may lead to development and maintenance of persistent pain. We describe the advances in the non-SCD pain field that may help improve the understanding of SCD pain. We highlight the need for further investigation in this area because some of these patients with persistent pain may benefit from receiving adjuvant mechanism-based therapies used successfully in other non-SCD chronic pain conditions.
疼痛性血管闭塞危象（VOCs）是镰状细胞病（SCD）的标志；然而，许多患者每天都经历频繁的疼痛，这种疼痛并不遵循典型VOCs的模式。这种严重程度不一的疼痛，在SCD文献中也被称为持续性疼痛，会导致显著的发病率和生活质量下降，并且通常对标准的SCD治疗反应不佳。在本文中，我们简要描述SCD中遇到的疼痛类型，特别强调持续性疼痛。我们讨论疼痛处理改变作为一种潜在的促成机制，这可能导致持续性疼痛的发生和维持。我们描述了非SCD疼痛领域的进展，这可能有助于增进对SCD疼痛的理解。我们强调在这一领域进行进一步研究的必要性，因为一些患有持续性疼痛的患者可能会受益于接受在其他非SCD慢性疼痛病症中成功使用的基于机制的辅助治疗。
