Management of Sickle Cell Disease Complications Beyond Acute Chest
Evidence-based clinical care for sickle cell disease (SCD) has focused on the prevention and treatment of infections, acute pain, acute chest syndrome and central nervous system complications. As survival in the pediatric age group improves, this clinical focus has broadened to include complications and conditions that have been under-addressed in large clinical trials although associated with significant morbidity and mortality. In this session, through clinical case-focused discussion, we address renal complications, avascular necrosis (AVN) and complications associated with pregnancy.
Dr. Santosh Saraf will address acute and chronic renal complications of SCD. The renal system is among the most commonly affected organ systems and is associated with increased morbidity and early mortality. Dr. Saraf will discuss the clinical significance, the pathophysiology, and the evaluation and management approaches for kidney disease in patients with SCD.
Dr. Oyebimpe Adesina will discuss the evaluation and management of AVN. AVN causes progressive bone and joint disease that can be associated with significant physical limitations and chronic pain. Dr. Adesina will address the importance of screening for AVN, issues related to hydroxyurea use, management approaches including core decompression and total hip replacement and perioperative care.
Dr. Kim Smith-Whitley will focus on the complications of pregnancy in women with SCD. Pregnancy-related complications are multifactorial and lead to significant morbidity and mortality for both mother and child. Dr. Smith-Whitley will summarize these complications and will address selective and prophylactic transfusions, management approaches including the implementation of a systematic approach to care with a comprehensive, multidisciplinary team and research gaps.
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