Gupta Anubhav, Chaudhary Kiran, Kaushik Rajnish
Department of Transfusion Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital Delhi, India.
Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital Delhi, India.
Clin Med Insights Case Rep. 2020 Nov 3;13:1179547620970200. doi: 10.1177/1179547620970200. eCollection 2020.
For many years main stay of treatment for sickle cell anaemia was transfusion therapy. But repeated transfusions put the patient at risk of iron overload. Automated red cell exchange is an evolving and newer technique which rapidly removes the sickle cells and has benefit in decreasing sickle cell load and related complications. Red cell exchange is a therapeutic procedure in which the patient's whole blood is processed centrifugally in cell separator. Patient's red cells are separated from other blood components and removed and replaced with donor red cells and colloids. We report our first experience of automated red cell exchange in 24-year-old female diagnosed case of sickle cell anaemia presented to us with acute chest syndrome with septic shock. Red cell exchange was planned to tide over the acute sickle cell crisis and provide symptomatic improvement. We also highlight that compound heterozygous thalassaemia could be associated with sickle cell disease which could make the diagnosis difficult. New generation automated Apheresis equipment's provides better monitoring of the procedure that can be useful in severely ill patients also.
多年来，输血疗法一直是镰状细胞贫血的主要治疗手段。但反复输血会使患者面临铁过载的风险。自动红细胞置换是一种不断发展的新技术，它能迅速清除镰状细胞，有助于降低镰状细胞负荷及相关并发症。红细胞置换是一种治疗程序，在细胞分离器中对患者的全血进行离心处理。将患者的红细胞与其他血液成分分离并去除，然后用供体红细胞和胶体进行置换。我们报告了对一名24岁诊断为镰状细胞贫血的女性患者进行自动红细胞置换的首次经验，该患者因急性胸部综合征合并感染性休克前来就诊。计划通过红细胞置换来度过急性镰状细胞危机并改善症状。我们还强调，复合杂合子地中海贫血可能与镰状细胞病相关，这可能会使诊断变得困难。新一代自动血液成分单采设备能更好地监测该程序，对重症患者也很有用。
