Near-Fatal Hepatic Crisis in A Sickle Cell Disease School-Going Child
Lere P. Oluwadare
*
Division of Early Childhood Development, Neurology and Infectious Diseases, Department of Paediatrics, Redeemer’s Health Village, Redemption City, Ogun State, Nigeria.
Pauline K. Akowundu
Division of Neonatology, General Paediatrics and Adolescent Medicine, Department of Paediatrics, Redeemer’s Health Village, Redemption City, Ogun State, Nigeria.
Christian E. Amiwero
Department of Haematology and Blood Transfusion Services, Redeemer’s Health Village, Redemption City, Ogun State, Nigeria.
Adebowale T. Odunafolabi
Division of General and Laparoscopic Surgery, Department of Surgery, Redeemer’s Health Village, Redemption City, Ogun State, Nigeria. and Department of Surgery, Faculty of Clinical Sciences, College of Medicine, Afe Babalola University, Ado-Ekiti, Nigeria.
Sampson C. Aliozor
Division of Paediatric Surgery, Department of Surgery, Redeemer’s Health Village, Redemption City, Ogun State, Nigeria.
Oluwasegun A. Adebisi
Division of Neonatology, General Paediatrics and Adolescent Medicine, Department of Paediatrics, Redeemer’s Health Village, Redemption City, Ogun State, Nigeria.
Abimbola S. Ajayi
Division of Early Childhood Development, Neurology and Infectious Diseases, Department of Paediatrics, Redeemer’s Health Village, Redemption City, Ogun State, Nigeria.
Odutola I. Odetunde
Department of Paediatrics, Faculty of Clinical Sciences, College of Medicine, University of Nigeria, Nsukka, Nigeria., Paediatric Nephrology Unit, Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria. and Division of Nephrology and Paediatric Critical Care, Department of Paediatrics, Redeemer’s Health Village, Redemption City, Ogun State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
A 10-year-old girl, known Haemoglobin (Hb) SS patient (new to our facility, the Redeemer’s Health Village), presented on account of headache, abdominal pain, fever, paleness of the body and yellowness of the eyes. Pertinent examination findings revealed a school age female, conscious but lethargic, in significant painful distress, pale and deeply jaundiced. Liver function profile was grossly deranged. Radiological investigations were deferred because the child was gravely ill at presentation. Her level of consciousness became altered on the second day of admission (Hepatic Encephalopathy Grade III, West Haven Criteria). Urgent exchange blood transfusion was done with HbA blood. Her clinical status steadily improved. She was allowed home in the second week of admission. She has remained clinically stable during the outpatient clinic visits subsequently.
Keywords: Sickle cell, vaso-occlusive crisis, hepatopathy, haematocrit, exchange blood transfusion