I want to make sure I continue to deliver content that is valuable and timely. In support of that effort I plan to repurpose the BRIEFS to cover quick, high yield topics, and post a new one each Thursday. I’ll include one article that I feel encapsulates the topic at hand and allows readers to delve deeper.

[divider scroll_text=””]

[frame src=”http://people.duke.edu/~ema5/Golian/Slides/5/hematology5_files/Hem055.jpg” width=”IMAGE_WIDTH” height=”IMAGE_HEIGHT” lightbox=”on” title=”Dactylitis” align=”center” ] The case: you are seeing a nine month old male with sickle cell anemia and dactylitis of his right hand. Dad is wondering what his son’s chances of having acute chest syndrome, like his older brother did, are in the future.

To answer this questions it is important to know the three prognostic factors that have been associated with adverse outcome in sickle cell disease:

  • Dactylitis in infants younger than 1 year of age
  • Hemoglobin level less than 7 g/L
  • Leukocytosis in the absence of infection


These adverse outcomes include:
  • Death
  • Increased risk of stroke
  • High overall rate of pain crises
  • Recurrent acute chest syndrome