Case Study 89 - Sickle Cell Anemia
1) What precipitating factors probably triggered this painful crisis?
The precipitating factors that probably triggered this painful crisis include working out
and playing basketball, low oxygen levels due to lack of profusion from over exertion and
dehydration.
2) What specifically is causing the patient’s current pain crisis?
Vasoconstriction in the lower extremities and arms from hypoxia is causing the patient's
current pain crisis.
3) Identify the patient’s two major risk factors for sickle cell anemia.
The patient’s two major risk factors for sickle cell anemia would be his family history
since both his mother and father tested positive for sickle cell trait and his younger brother has
the sickle cell trait. Also, African Americans are more predisposed to obtaining the sickle cell
trait which also increases his risk for sickle cell anemia.
4) Which single clinical finding provided a definitive diagnosis of sickle cell anemia.
The single clinical finding that provided a definitive diagnosis of sickle cell anemia
includes the patient's diagnosis of homozygous HbS disease at 11 months with electrophoresis
that revealed a hemoglobin proportion of 86.5% HbS, 11.3% HbF, and 2.2% HbA2.
5) Excluding laboratory test results, list a minimum of eight clinical manifestations or
complications from this case that are consistent with a diagnosis of sickle cell
anemia.
Eight clinical manifestations or complications from this case that are consistent with a
diagnosis of sickle cell anemia include family history, extreme fatigue, limited range of motion
in elbows, wrists, knees and ankles, dry nasal and oral mucosa membranes, dry lips, warm and
dry skin with poor turgor, systolic ejection murmur is prominent, and multiple infections and
attacks when he was younger.
1) What precipitating factors probably triggered this painful crisis?
The precipitating factors that probably triggered this painful crisis include working out
and playing basketball, low oxygen levels due to lack of profusion from over exertion and
dehydration.
2) What specifically is causing the patient’s current pain crisis?
Vasoconstriction in the lower extremities and arms from hypoxia is causing the patient's
current pain crisis.
3) Identify the patient’s two major risk factors for sickle cell anemia.
The patient’s two major risk factors for sickle cell anemia would be his family history
since both his mother and father tested positive for sickle cell trait and his younger brother has
the sickle cell trait. Also, African Americans are more predisposed to obtaining the sickle cell
trait which also increases his risk for sickle cell anemia.
4) Which single clinical finding provided a definitive diagnosis of sickle cell anemia.
The single clinical finding that provided a definitive diagnosis of sickle cell anemia
includes the patient's diagnosis of homozygous HbS disease at 11 months with electrophoresis
that revealed a hemoglobin proportion of 86.5% HbS, 11.3% HbF, and 2.2% HbA2.
5) Excluding laboratory test results, list a minimum of eight clinical manifestations or
complications from this case that are consistent with a diagnosis of sickle cell
anemia.
Eight clinical manifestations or complications from this case that are consistent with a
diagnosis of sickle cell anemia include family history, extreme fatigue, limited range of motion
in elbows, wrists, knees and ankles, dry nasal and oral mucosa membranes, dry lips, warm and
dry skin with poor turgor, systolic ejection murmur is prominent, and multiple infections and
attacks when he was younger.
