Patel Jyotish, Patel Bharati, Serjeant Graham R
Chairman, Vision Medical Foundation for Rural Health and Research, Shishudeep Hospital, Bardoli, Gujarat, India.
Secretary, Vision Medical Foundation for Rural Health and Research, Shishudeep Hospital, Bardoli, Gujarat, India.
Indian J Community Med. 2017 Jul-Sep;42(3):167-169. doi: 10.4103/ijcm.IJCM_334_16.
Sickle cell disease is a common problem across central India, but its clinical features may differ from that in African populations. There is a need to define the features of sickle cell disease in India, and the current study addresses some features of the bone pain crisis.
The objective of the study was to describe the epidemiology of the bone pain crisis of sickle cell disease in Gujarat and explore the relationship with infection by .
This was a prospective review of all admissions in patients with sickle cell disease to a private pediatric institution in Bardoli, Gujarat, in the year 2015. Hemoglobin electrophoresis of all patients was consistent with homozygous sickle cell disease, but family studies indicated that at least seven cases had the severe sickle cell-beta + thalassemia presumed to be the common IVS1-5G>C mutation. Clinical, hematological, and parasitological features were recorded.
There were 914 admissions among 654 patients who had between one and seven admissions. The bone pain crisis accounted for 763 (83%) of admissions and increased between July and October coinciding with the monsoon period. Blood smears were examined for malarial parasites in 811 admissions and were positive for in 73% patients. There was no evidence that infections varied with the cause of admission or increased during the monsoon period.
There was a high prevalence of infection in hospital admissions of sickle cell patients, but the data did not support an etiological role in the bone pain crisis. A trial of malarial prophylaxis might determine its effect on the clinical features and outcome of sickle cell disease.
镰状细胞病在印度中部是一个常见问题，但其临床特征可能与非洲人群不同。有必要明确印度镰状细胞病的特征，当前研究探讨了骨痛危象的一些特征。
本研究的目的是描述古吉拉特邦镰状细胞病骨痛危象的流行病学情况，并探讨其与[病原体名称缺失]感染的关系。
这是一项对2015年入住古吉拉特邦巴尔多利一家私立儿科机构的镰状细胞病患者的所有住院病例进行的前瞻性回顾研究。所有患者的血红蛋白电泳结果均符合纯合子镰状细胞病，但家族研究表明，至少有7例患有严重的镰状细胞-β+地中海贫血，推测为常见的IVS1-5G>C突变。记录了临床、血液学和寄生虫学特征。
654例患者共住院914次，每人住院1至7次。骨痛危象占住院病例的763例（83%），在7月至10月的季风期有所增加。对811例住院病例的血涂片进行了疟原虫检查，73%的患者呈阳性。没有证据表明[病原体名称缺失]感染因入院原因而异，也没有证据表明在季风期会增加。
镰状细胞病患者住院时[病原体名称缺失]感染的患病率较高，但数据不支持其在骨痛危象中的病因学作用。疟疾预防试验可能会确定其对镰状细胞病临床特征和结局的影响。
