Sickle Cell Hepatic Vaso-Occlusive Crisis: A Case Report

Area of Science:

• Hematology
• Hepatology
• Genetics

Background:

• Sickle cell disease (SCD) is an inherited blood disorder caused by a specific gene mutation.
• It leads to abnormal hemoglobin, causing red blood cells to sickle, leading to vaso-occlusion and organ damage.
• Hepatic involvement, including vaso-occlusive crisis (VOC), is a serious complication of SCD.

Purpose of the Study:

• To report a case of rapidly progressive hepatic VOC in a patient with homozygous sickle cell anemia.
• To explore the potential role of metronidazole as an adjunctive therapy in managing sickle cell-related hepatic complications.

Main Methods:

• Case report of a 25-year-old female with homozygous sickle cell anemia.
• Presentation of a rapidly progressive hepatic VOC following a respiratory illness.
• Multimodal management including supportive care, corticosteroids, blood transfusion, and intravenous metronidazole.

Main Results:

• The patient experienced acute abdominal pain, severe transaminitis, cholestasis, and hepatomegaly.
• Clinical and biochemical improvement was observed after the multimodal treatment.
• Intravenous metronidazole was added to the treatment regimen.

Conclusions:

• Hepatic VOC is a significant and potentially life-threatening complication of SCD.
• Metronidazole may have a role as an adjunctive therapy in sickle cell-related vaso-occlusive complications due to its anti-inflammatory properties.
• Further research is needed to confirm the therapeutic efficacy of metronidazole in SCD-related complications.