Journal Article Epublish 9 citations
PubMed: 37850770 DOI: 10.23750/abm.v94i5.14603
Clinical and epidemiological features and therapeutic options of avascular necrosis in patients with sickle cell disease (SCD): a cross-sectional study.
Acta Biomed 94(5):e2023198
Authors: Awni Alshurafa, Ashraf T Soliman, Vincenzo De Sanctis, Omar Ismail, Mohammad Abu-Tineh, Mohammad Khair Eddin Hemadneh, Farah Rahat Rashid, Khadra Yassin, Hana Qasim, Abdulqadir Jeprel Nashwan, Mohamed A Yassin
Affiliations
- Hamad Medical Corporation.
Abstract
BACKGROUND
Avascular necrosis (AVN) is a debilitating complication in sickle cell disease (SCD) patients, and its management is usually challenging. This study aims to evaluate the clinical and epidemiological features and therapeutic options of AVN in sickle cell patients in Qatar.
PATIENTS AND METHODS
A cross-sectional study was conducted on a 49 SCD patients who were diagnosed with AVN and attended the hematology clinic at the National Center for Cancer care & research, Hamad Medical Corporation, Qatar between Jan-2011 to Jan2021. Â Results: Forty-nine adult patients with SCD who were diagnosed with AVN were studied. The median age of the study population is 32 years, and the median age at the first AVN diagnosis was 26 years (range: 11-44 yr.). 37 (75.5%) patients suffered from multiple joints AVN while 12(24.5%) had single joint involvement. 31 (63.3%) patients had bilateral hip AVN and 18 (36.7%) had shoulder involvement. 30 patients (61%) were on Hydroxyurea treatment. Based on FICAT and Alert classification of AVN, 57 % of patients had stage III and above at first diagnosis. 20 (40.8%) were managed with a conservative approach, 11 (22.4%) received hyperbaric oxygen with good response, 6(12.2%) underwent hip core decompression and 12(24.5%) underwent hip replacement surgery.
CONCLUSION
In SCD patients, AVN occurred more during the 3rd and 4th decades of life. The majority of AVN represented with advanced stage and had multiple joint involvements. We recommend adopting a low threshold of joint imaging for early detection and prevention of further complications.
MeSH
Cells, Cross-Sectional Studies, Anemia, Sickle Cell, Necrosis, Diagnosis, Therapeutics
Cited by
- Comparative analysis of intra- and interobserver reliability and validity of five basic classifications used to determine the stage of avascular necrosis of the femoral head. BMC Musculoskelet Disord, 2025
- Long-term outcomes of avascular necrosis in sickle cell disease using joint-specific patient-reported outcome measures: Results from a multicentre study. Br J Haematol, 2025