[Carpal Extensor Tenosynovitis and Adult Sickle Cell Vaso-Occlusive Crisis]

Area of Science:

• Rheumatology
• Hematology
• Pediatrics

Background:

• Osteoarticular complications are common in sickle cell anemia.
• Hand-foot syndrome (dactylitis) is a characteristic manifestation typically observed in children under four years old.
• Its occurrence in adults is exceptionally rare.

Purpose of the Study:

• To report a unique case of hand-foot syndrome in an adult with sickle cell disease (SS).
• To describe the clinical presentation and diagnostic considerations for this rare manifestation.
• To emphasize the importance of considering vaso-occlusive complications in adult sickle cell disease.

Main Methods:

• Case report of a 36-year-old adult with homozygous sickle cell disease (SS).
• Clinical observation of hand-foot syndrome during a vaso-occlusive crisis, presenting as tenosynovitis of carpal extensors.
• Differential diagnosis to exclude infectious etiologies of palmar tenosynovitis.

Main Results:

• The adult patient presented with tenosynovitis mimicking infection but was diagnosed with hand-foot syndrome.
• The vaso-occlusive origin of the tenosynovitis was confirmed by the rapid clinical improvement.
• This case expands the known age range for hand-foot syndrome in sickle cell disease.

Conclusions:

• Hand-foot syndrome can occur in adult patients with sickle cell disease (SS), albeit rarely.
• Vaso-occlusive crises should be considered in the differential diagnosis of tenosynovitis in adults with sickle cell disease.
• This case underscores the diverse clinical spectrum of sickle cell anemia complications.