scholarly journals Sickle Cell Trait Presenting as Unilateral Proliferative Retinopathy and Macular Thinning in a Pregnant Woman

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Sepideh Ghods ◽  
Elias Khalili Pour ◽  
Hooshang Faghihi ◽  
Golnaz Gharehbaghi ◽  
Ahmad Mirshahi ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Fasting Blood Glucose ◽  
Vitreous Hemorrhage ◽  
Skin Tests ◽  
Retinal Layer ◽  
Case Presentation ◽  
Funduscopic Examination ◽  
Sea Fan

Background. To report a case of a pregnant woman with sickle cell trait (SCT) who presented with unilateral proliferative sickle cell retinopathy. Case Presentation. A 26-year-old otherwise healthy pregnant woman presented with the complaint of visual loss in her left eye. The funduscopic examination showed vitreous hemorrhage, sea fan neovascularization, and pale optic disc. Optical coherence tomography revealed macular inner retinal layer thinning and foveal splaying (saucerization of the foveal pit). The investigations, including hemoglobin electrophoresis, verified the diagnosis of sickle cell trait. Blood pressure, fasting blood glucose tests, and tuberculin skin tests were normal. We treated the patient by peripheral retinal photocoagulation over the area of nonperfusion. Conclusion. Even though the sickle cell trait is generally considered as a milder form of sickle cell disease without severe retinal manifestations, pregnancy should be considered as a trigger that can induce proliferative changes and foveal splaying in this group of patients.

Intravitreal Bevacizumab for Proliferative Sickle Retinopathy: A Case Series

2017 ◽  
Vol 2 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Cindy X. Cai ◽  
Marguerite O. Linz ◽  
Adrienne W. Scott
Keyword(s):  
Sickle Cell ◽  
Large Scale ◽  
Case Series ◽  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Beta Thalassemia ◽  
Intravitreal Bevacizumab Injection ◽  
Initial Injection ◽  
Sea Fan ◽  
Recurrent Vitreous Hemorrhage

Purpose: To report outcomes of intravitreal bevacizumab therapy for proliferative sickle retinopathy (PSR). Methods: A retrospective, interventional case series. Five eyes of 5 patients with PSR were managed with intravitreal bevacizumab therapy over a 13-year period at a single institution. Results: Four patients had sickle cell-hemoglobin SC disease and 1 had sickle cell-beta thalassemia disease. Four of the patients treated with intravitreal bevacizumab injection were treated for recurrent vitreous hemorrhage and 1 was treated for new peripheral sea fan neovascularization. In those patients treated for vitreous hemorrhage, there was improvement in visual acuity as early as 2 weeks after treatment. Only 2 of the patients had documented recurrent vitreous hemorrhage during the period of follow-up after the initial injection. In 1 patient, the vitreous hemorrhage did not recur until 13 months after the injection. All patients showed an anatomic response to intravitreal bevacizumab therapy with partial regression of the peripheral sea fan neovascularization. All patients tolerated the injections without any complications. Conclusions: Intravitreal bevacizumab injections appear to be well tolerated and may be an effective treatment of PSR. Regression of peripheral sea fan neovascularization and decreased duration of vitreous hemorrhage may be observed. Large-scale randomized controlled trials are needed to further clarify the role of bevacizumab in PSR.

scholarly journals Fatal Sickling Associated Microvascular Occlusive Crisis in a Young Military Recruit with Sickle Cell Trait: A Case Report

2020 ◽  
Author(s):  
Deepti Mutreja ◽  
Benjith Paul K ◽  
Tilak T V S V G K ◽  
Vanmalini Tewari
Keyword(s):  
Sickle Cell ◽  
Indian Population ◽  
Sickle Cell Trait ◽  
Armed Forces ◽  
Cell Disease ◽  
Military Recruit ◽  
Metabolic Complications ◽  
Case Presentation ◽  
Training Activities ◽  
The Individual

Abstract Background. Sickle cell trait(SCT), a heterozygous state characterized by the presence of hemoglobin AS, occurs in varied frequency in the Indian population with highest prevalence in Central and southern India. SCT is compatible with a normal lifespan and not commonly regarded as a cause of morbid illness or death in contrast to sickle cell disease, its homozygous counterpart. Case Presentation. We describe a case of fatal sickling associated microvascular crisis, identified on post mortem evaluation in a previously undiagnosed 20-year-old military recruit with sickle cell trait. The individual presented with repeated episodes of presyncope during his training and was evaluated for cardiac anomalies and heat syncope. During the terminal episode, he collapsed and died of severe metabolic complications as he struggled to complete an organised run during routine training activities. Conclusion. To our knowledge, this is the first report of fatal sickling associated crisis in a military recruit with sickle cell trait from India. This case serves to remind all medical officers of the armed forces of the importance of screening a recruit who is unable to complete exertional physical training for the presence of sickle cell trait.

scholarly journals Massive ocular hemorrhage resulting in blindness in a patient with the sickle cell trait who developed leptospirosis. Case report

2000 ◽  
Vol 42 (5) ◽  
pp. 287-289 ◽  
Author(s):  
Everaldo COSTA ◽  
Antonio Alberto LOPES ◽  
Edilson SACRAMENTO ◽  
Paulo Afonso B. SANTOS
Keyword(s):  
Case Report ◽  
Sickle Cell ◽  
Black Male ◽  
Sickle Cell Trait ◽  
Vitreous Hemorrhage ◽  
Ocular Complication ◽  
Blurred Vision ◽  
Muscular Pain ◽  
Northeastern State

This case report describes the findings of a 18 year-old black male from Bahia, a Northeastern state in Brazil, with the sickle cell trait, who developed bilateral hyphema and vitreous hemorrhage with blindness in the course of leptospirosis. The patient started to complain of blurred vision four days after the start of fever and muscular pain and approximately twelve hours after the introduction of penicillin. The severity of the leptospirosis in conjunction with sickle cell trait was considered to be the most likely explanation for this ocular complication.

Vitreous hemorrhage secondary to sickle cell trait

2020 ◽  
Vol 43 (4) ◽  
pp. e147-e149
Author(s):  
O. Fekih ◽  
A. Abdeljelil ◽  
H. Zgolli ◽  
L. Nacef
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Vitreous Hemorrhage

scholarly journals Clinical Features and Surgical Outcomes of Subretinal Proliferation in Proliferative Diabetic Retinopathy

2020 ◽  
Author(s):  
Chan Wu ◽  
Dai Rongping ◽  
Youxin Chen ◽  
Xiao Zhang ◽  
Zhe Chen
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Silicone Oil ◽  
Fasting Blood Glucose ◽  
Vitreous Hemorrhage ◽  
Control Group ◽  
Study Group ◽  
Systemic Involvement ◽  
Funduscopic Examination ◽  
Sugar Levels

Abstract Background: To investigate the clinical characteristics, treatments and prognosis of subretinal proliferation (SRP) in patients with proliferative diabetic retinopathy (PDR).Methods: 154 patients (182 eyes) who received vitrectomy for PDR were retrospectively reviewed. Patients with SRP were enrolled as the study group, and those without SRP served as the control group. The following data were collected from their medical records: demographics, systemic and ophthalmologic findings, and treatment given specifically for SRP. The main outcome measures included the visual acuity, funduscopic examination and final anatomic success. The association between SRP and other systemic involvement of PDR was also analyzed. Results: There were 9 eyes (9 patients) in the study group and 145 eyes (145 patients) in the control group. The average fasting blood glucose was 11.48 ± 3.52 mmol/L and 8.72 ± 3.05 mmol/L, respectively (P = .048). The study group had a significantly higher proportion of tractional retinal detachment (TRD) (P < .0001) and a significantly lower proportion of vitreous hemorrhage (VH) (P = .0006). The rate of silicone oil usage was higher in the study group (P < .0001). No retinal break was found preoperatively or intraoperatively. Only one eye (11.1%) had undergone subretinal band removal procedure intraoperatively, and the final anatomical success rate was 100%. Conclusion: SRP in PDR was associated with higher blood sugar levels and TRD. The retina could reattach successfully after vitrectomy without removal or transection of the subretinal bands in most eyes.

Sickle cell trait and the eye

1977 ◽  
Vol 137 (3) ◽  
pp. 281a-281
Author(s):  
P. E. Mickelson
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Trait

Microsurgery in the Sickle Cell Trait Population: Is It Actually Safe?

2020 ◽  
pp. 1-2
Author(s):  
Michael Alperovich ◽  
Eric Park ◽  
Michael Alperovich ◽  
Omar Allam ◽  
Paul Abraham
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Free Flap ◽  
Near Infrared ◽  
Sickle Cell Trait ◽  
Cell Disease ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Patient Reported ◽  
Deep Inferior Epigastric Perforator

Although sickle cell disease has long been viewed as a contraindication to free flap transfer, little data exist evaluating complications of microsurgical procedures in the sickle cell trait patient. Reported is the case of a 55-year-old woman with sickle cell trait who underwent a deep inferior epigastric perforator (DIEP) microvascular free flap following mastectomy. The flap developed signs of venous congestion on postoperative day two but was found to have patent arterial and venous anastomoses upon exploration in the operating room. On near-infrared indocyanine green angiography, poor vascular flow was noted despite patent anastomoses and strong cutaneous arterial Doppler signals. Intrinsic microvascular compromise or sickling remains a risk in the sickle cell trait population as it does for the sickle cell disease population. Just like in sickle cell disease patients, special care should be taken to optimize anticoagulation and minimize ischemia-induced sickling for patients with sickle cell trait undergoing microsurgery.

scholarly journals COVID-19 as a trigger for splenic infarction in a patient with sickle cell trait: a case report

2021 ◽  
pp. 100047
Author(s):  
Álvaro Alejandre-de-Oña ◽  
Jaime Alonso-Muñoz ◽  
Pablo Demelo-Rodríguez ◽  
Jorge del-Toro-Cervera ◽  
Francisco Galeano-Valle
Keyword(s):  
Case Report ◽  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Splenic Infarction

scholarly journals Metabolism of Heterogenic Hemoglobins

Blood ◽  
1963 ◽  
Vol 22 (3) ◽  
pp. 334-341 ◽  
Author(s):  
RICHARD D. LEVERE ◽  
HERBERT C. LICHTMAN ◽  
Joan Levine
Keyword(s):  
Pulmonary Tuberculosis ◽  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Hemoglobin S ◽  
Active Pulmonary Tuberculosis ◽  
Hemoglobin A ◽  
Abnormal Hemoglobin

Abstract The relative rates of incorporation of Fe59 into heterogenic hemoglobins was studied in four patients with sickle cell trait. Three of the patients were free of superimposed disease, while one had active pulmonary tuberculosis. In all subjects there was a significantly greater incorporation of radioiron, per milligram of hemoglobin, into hemoglobin S than into hemoglobin A. The data indicate that in sickle cell trait the rates of synthesis of the heterogenic hemoglobins are not proportional to their circulating concentrations. Two interpretations appear possible. Since the size of the intra-marrow pool of hemoglobin S was not known, it is possible that there exists a smaller preformed pool of the abnormal hemoglobin, with the isotope making its appearance first in hemoglobin S. However, it is also possible that hemoglobin S is synthesized at a rate which is greater than that reflected by its circulating concentration. This implies that the relative concentrations of hemoglobin S and hemoglobin A vary from erythrocyte to erythrocyte, and that those cells with the greatest proportion of hemoglobin S are selectively destroyed.

scholarly journals To Give or Not to Give: RhD Immunoglobulin for an RHD*39 Pregnant Woman with Sickle Cell Disease

2021 ◽  
pp. 1-5
Author(s):  
Justin E. Juskewitch ◽  
Craig D. Tauscher ◽  
Sheila K. Moldenhauer ◽  
Jennifer E. Schieber ◽  
Eapen K. Jacob ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Pregnancy Termination ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Childbearing Age ◽  
Procedural Complications ◽  
History Of ◽  
Chronic Hemolysis

Introduction: Patients with sickle cell disease (SCD) have repeated episodes of red blood cell (RBC) sickling and microvascular occlusion that manifest as pain crises, acute chest syndrome, and chronic hemolysis. These clinical sequelae usually increase during pregnancy. Given the racial distribution of SCD, patients with SCD are also more likely to have rarer RBC antigen genotypes than RBC donor populations. We present the management and clinical outcome of a 21-year-old pregnant woman with SCD and an RHD*39 (RhD[S103P], G-negative) variant. Case Presentation: Ms. S is B positive with a reported history of anti-D, anti-C, and anti-E alloantibodies (anti-G testing unknown). Genetic testing revealed both an RHD*39 and homozygous partial RHCE*ceVS.02 genotype. Absorption/elution testing confirmed the presence of anti-G, anti-C, and anti-E alloantibodies but could not definitively determine the presence/absence of an anti-D alloantibody. Ms. S desired to undergo elective pregnancy termination and the need for postprocedural RhD immunoglobulin (RhIG) was posed. Given that only the G antigen site is changed in an RHD*39 genotype and the potential risk of RhIG triggering a hyperhemolytic episode in an SCD patient, RhIG was not administered. There were no procedural complications. Follow-up testing at 10 weeks showed no increase in RBC alloantibody strength. Discussion/Conclusion: Ms. S represents a rare RHD*39 and partial RHCE*ceVS.02 genotype which did not further alloimmunize in the absence of RhIG administration. Her case also highlights the importance of routine anti-G alloantibody testing in women of childbearing age with apparent anti-D and anti-C alloantibodies.

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