IHTC NEWS:
09.11.2010 - Sickle Cell-abration 2010
The IHTC is sponsoring a free concert to raise awareness of sickle cell disease! Come and enjoy a diverse blend of music at the Madame Walker Theater. The free concert is from 5 to 9 pm; doors open at 4:30 pm. You may also choose to share the gift of life with those who have sickle cell disease by...
04.20.2010 - IHTC voted one of Indiana's best workplaces!
As reported in the IndyStar, over 600 companies in central Indiana were invited by Workplace Dynamics of Exton, PA, to participate in a workplace survey in January 2010. Nearly 20,000 employees from 101 large, middle, and small companies voted on their workplace management,...
Sickle Cell Disease
Aplastic Crisis and Intervention
An aplastic crisis should not be confused with hemolytic anemia, which is a constant feature of sickle cell disease. The aplastic crisis is temporary cessation of red cell production. Because of the markedly shortened red cell survival time in patients with sickle cell disease, a precipitous drop in hemoglobin occurs in the absence of adequate reticulocytosis.
Among patients with sickle cell disease, severe aplastic crisis is frequently (86% oses) associated with parvovirus B 19 infections (childhood fifth disease). Other causes may be EBV or Strep infection as well as use of hydroxyurea. Patients typically present with increased fatigue, pallor, activity intolerance or shortness of breath. Pallor may replace the typical jaundice of sickle cell disease. The period of viremia lasts about one week. The CBC reveals a lower than relative normal hemoglobin and a decreased reticulocyte count. The aplasia usually persists for 5-10 days. Pancytopenia does not usually occur. The treatment is management of symptoms of anemia with simple transfusion using extended antigen-typed, leukodepleted PRBCs. Recovery is heralded by increased peripheral NRBCs followed by reticulocytosis, This phase of recovery is also often marked by hyperbilirubinemia, and called a “hyperhemolytic” phase. The incidence of recurrent parvovirus B 19 is very low. IgM titers begin to rise by about day 7 and peak by day 21. As normal erythroid function returns, IgG rises and remains elevated, indicating past infection. If the patient develops an aplastic crisis off folic acid supplementation, it is wise to initiate or resume 1mg daily, as folate deficiency will slow recovery. Children in the general community do not require isolation. Patients admitted to the hospital are often managed in isolation. Hematologically normal people who are infected by parvovirus usually do not develop red cell aplasia or other serious complications.
