Acute Pancreatitis in Individuals with Sickle Cell Disease: A Systematic Review

Area of Science:

• Hematology
• Gastroenterology
• Public Health

Background:

• Sickle cell disease (SCD) affects 100,000 individuals in the US, increasing risks for gallstones and ischemia.
• These complications may elevate the risk of acute pancreatitis (AP) in SCD patients.
• Abdominal pain is a shared symptom of AP and sickle cell vaso-occlusive crisis, complicating diagnosis.

Purpose of the Study:

• To systematically review and estimate the prevalence of AP in individuals with SCD.
• To determine the severity of AP in SCD patients compared to the general population.

Main Methods:

• Systematic review of multiple electronic databases.
• Inclusion of studies with pediatric and adult populations comparing SCD patients with AP to those without.
• Independent screening of titles/abstracts and duplicated data abstraction.

Main Results:

• 33 studies were identified from 296 screened, including case reports, a case series, and retrospective cohorts.
• AP complications in SCD cases included respiratory issues, splenic complications, pancreatic pseudocyst, and one death.
• Estimated AP prevalence in SCD ranged from 2% to 7% in two studies; biliary disease as an AP etiology in children with SCD was 12%-34%.

Conclusions:

• Current data on AP prevalence in individuals with SCD are limited.
• Prospective studies are needed to proactively assess AP in SCD patients presenting with abdominal pain.
• Improved diagnostic strategies are crucial for timely AP diagnosis and better outcomes in SCD.