Deep Vein Thrombosis of the Left Lower Limb in a Sudanese Child with Sickle Cell Disease

Abstract

This is a case of an eleven-year-old female Sudanese child, a known Sickle Cell Anemia (SCA) patient, who presented with fever, as well as left thigh and leg swelling that was associated with pain and warmness, which was diagnosed as Deep Vein Thrombosis (DVT) of her left lower limb. She had a previous history of admissions to the emergency room, during which she once received blood. The patient was managed by carrying out a basic routine initial laboratory investigation. A Doppler ultrasound scan showed features consistent with DVT. Based on the clinical findings and investigation results, management began by providing the patient with intravenous fluid, analgesia, packed Red Blood Cells (RBCs), intravenous antibiotics, and low-molecular-weight heparin. Further consultations showed that there was no need for vascular surgery or surgical intervention. This case highlights the need for more studies on DVT and Venous Thromboembolism (VTE) complications in children with SCA, so as to develop strategies for diagnosis and management in order to reduce the risk of life-threatening complications of VTE in patients with Sickle Cell Disease SCD.

Keywords: Sudanese; deep vein thrombosis; sickle cell disease.

Figure 1

(A) Patient on initial presentation, left thigh swelling (mid-thigh circumference 31 cm). Right thigh (mid-thigh circumference 25 cm); (B) Patient on initial presentation, left leg swelling (mid-leg circumference 26 cm). right mid-leg circumference 20.5 cm and (C) Patient on initial presentation, left and right leg X-ray.

Figure 2

(A) Patient on initial presentation, Doppler ultrasound, and (B) after one week from management.