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Case Reports
. 2011:2011:975731.
doi: 10.1155/2011/975731. Epub 2010 Dec 21.

Intrahepatic cholestasis in sickle cell disease: a case report

Denise Menezes Brunetta  1 , Ana Cristina Silva-Pinto, Maria do Carmo Favarin de Macedo, Sarah Cristina Bassi, Joao Victor Piccolo Feliciano, Fernanda Borges Ribeiro, Benedito de Pina Almeida Prado Jr, Gil Cunha De Santis, Ivan de Lucena Angulo, Dimas Tadeu Covas
Affiliations
Case Reports

Intrahepatic cholestasis in sickle cell disease: a case report

Denise Menezes Brunetta et al. Anemia. 2011.

Abstract

Intrahepatic cholestasis (SCIC) is an uncommon but potentially fatal complication of sickle cell disease (SCD), with a high death rate, observed mainly in patients with homozygous sickle cell anemia. Herein, we describe a case of severe SCIC treated successfully with aggressive manual exchange transfusion (ET). The patient was admitted with enlarged liver and signs of hepatic failure, such as hyperbilirubinemia and coagulopathy. There was no evidence of viral hepatitis or biliary obstruction. We performed several sessions of ET in order to reduce the percentage of HbS to levels inferior to 30%, which was successfully accomplished. The patient had a complete recovery of hepatic function. This case has shown that ET is an effective treatment of SCIC and should be introduced early on the onset of this severe complication.

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Figures

Figure 1
Figure 1
Exchange transfusion and evolution of bilirubin levels, hemoglobin S (HbS) percentage and INR according to the day of hospital admission.
See this image and copyright information in PMC

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