Sickle cell anemia: a mimicker of rheumatoid arthritis
DOI:
https://doi.org/10.18203/2349-3933.ijam20230072Keywords:
Sickle cell anemia, Vaso-occlusive crisis, Rheumatoid arthritis, Exchange transfusionAbstract
Sickle cell disease (SCD) is a genetic disorder characterized by presence of abnormal hemoglobin S, leading to sickling of RBCs. The prevalence of sickle cell carriers among different tribal groups varies from 1-40%. Rheumatoid arthritis closely mimics the bone crisis symptoms in sickle cell anemia hence prompt diagnosis should be made to commence correct choice of treatment. We reported an 18 year old female with sickle cell disease who presented multiple intermittent joint pain of both limbs for 6 years with acute worsening of pain for the past 7 days. Diagnosis of sickle cell anemia becomes important as musculoskeletal manifestations of the disease can mirror the symptoms of inflammatory arthritis and the treatment given for rheumatoid arthritis can potentially worsen the condition in patients with sickle cell anemia.
References
Bhatia HM, Rao VR. Genetic atlas of the Indian tribes. Bombay: ICMR; 1987.
Bunn HF. Pathogenesis and treatment of sickle cell disease. N Engl J Med. 1997;337(11):762-9.
Odièvre MH, Verger E, Silva-Pinto AC, Elion J. Pathophysiological insights in sickle cell disease. Indian J Med Res. 2011;134(4):532-7.
Neumayr LD, Aguilar C, Earles AN, Jergesen HE, Haberkern CM, Kammen BF, et al. Physical therapy alone compared with core decompression and physical therapy for femoral head osteonecrosis in sickle cell disease. Results of a multicenter study at a mean of three years after treatment. J Bone Joint Surg Am. 2006;88(12):2573-82.
Espinoza LR, Spilberg I, Osterland CK. Joint manifestations of sickle cell disease. Medicine (Baltimore). 1974;53(4):295-305.
Michel M, Habibi A, Godeau B, Bachir D, Lahary A, Galacteros F, et al. Characteristics and outcome of connective tissue diseases in patients with sickle-cell disease: report of 30 cases. Semin Arthritis Rheum. 2008;38(3):228-40.
Patel J, Patel B, Serjeant GR. The Bone Pain Crisis of Sickle Cell Disease and Malaria: Observations from Gujarat, India. Indian J Community Med. 2017;42(3):167-9.
Darbari DS, Wang Z, Kwak M, Hildesheim M, Nichols J, Allen D, et al. Severe painful vaso-occlusive crises and mortality in a contemporary adult sickle cell anemia cohort study. PLoS One. 2013;8(11):e79923.
Darshana T, Rees D, Premawardhena A. Hydroxyurea and blood transfusion therapy for Sickle cell disease in South Asia: inconsistent treatment of a neglected disease. Orphanet J Rare Dis. 2021;16(1):148.
Ataga KI, Kutlar A, Kanter J, Liles D, Cancado R, Friedrisch J, et al. Crizanlizumab for the Prevention of Pain Crises in Sickle Cell Disease. N Engl J Med. 2017;376(5):429-39.