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一例伴有多器官受累的严重镰状细胞危象的挑战性病例:病例报告

A Challenging Case of Severe Sickle Cell Crisis With Multiorgan Involvement: A Case Report.

作者信息

Ibrahim Rana, Fadel Abbas, Sawli Nour, Mecheik Ali

机构信息

Research Department, Saint George Hospital-Hadath, Beirut, LBN.

Infectious Diseases Department, Saint George Hospital-Hadath, Beirut, LBN.

出版信息

Cureus. 2023 Jul 25;15(7):e42437. doi: 10.7759/cureus.42437. eCollection 2023 Jul.

Abstract

Sickle cell anemia is a chronic and debilitating hemoglobinopathy characterized by the presence of abnormal hemoglobin, resulting in the formation of sickle-shaped red blood cells. This case report presents an unusual case of a 32-year-old female patient with sickle cell anemia who had not experienced any previous sickle cell crises since her diagnosis at the age of four years. Despite a stable clinical history, the patient's condition rapidly deteriorated, leading to septic shock, multiorgan failure, and atypical complications such as neurological impairment and acute kidney injury. Intensive management strategies, including blood exchange, mechanical ventilation, and aggressive antibiotic therapy, were implemented but unfortunately failed to reverse the progressive clinical deterioration. This case underscores the importance of early recognition and a multidisciplinary approach in managing atypical sickle cell crises to optimize patient outcomes. Further research is needed to improve our understanding and management of such presentations.

摘要

镰状细胞贫血是一种慢性衰弱性血红蛋白病,其特征是存在异常血红蛋白,导致镰状红细胞的形成。本病例报告呈现了一例不同寻常的病例,一名32岁的镰状细胞贫血女性患者,自4岁确诊以来从未经历过任何镰状细胞危象。尽管临床病史稳定,但患者病情迅速恶化,导致感染性休克、多器官功能衰竭以及诸如神经功能障碍和急性肾损伤等非典型并发症。实施了包括换血、机械通气和积极抗生素治疗在内的强化管理策略,但遗憾的是未能扭转临床病情的进展。本病例强调了早期识别和多学科方法在管理非典型镰状细胞危象以优化患者结局方面的重要性。需要进一步研究以增进我们对此类表现的理解和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e85a/10448915/a79c148481d6/cureus-0015-00000042437-i01.jpg

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