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Sickle Cell Disease: A Comprehensive Review Of Inpatient Management

September 2014

Abstract

Since sickle cell disease was first formally reported in 1910, its management and treatment have greatly advanced, but hospitalists are still faced with a persistent challenge in managing adult patients with this disease. There continues to be a large number of emergency department visits and hospitalizations for adults with this chronic condition, leading to substantial healthcare costs in the United States, even with protocols to prevent readmissions and avoidable prolonged hospitalizations. This review examines relevant topics in the hospital management of sickle cell disease and aims to assist physicians in providing comprehensive and cost-effective care for their patients. The initial presentation, differential diagnosis, and treatment of common life-threatening complications in sickle cell disease (such as acute pain crisis and acute chest syndrome) are discussed. Treatment strategies, including the role of hydroxyurea, appropriate transfusions practices, cost-effective strategies, and quality improvement measures are also discussed.

Key words: sickle cell anemia, sickle cell disease, sickle cell trait, acute pain crisis, acute chest syndrome, transfusion

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