Vaso-occlusive crisis as a predictor of symptomatic avascular necrosis in children with sickle cell disease
Avascular necrosis (AVN) is a chronic bone complication of sickle cell disease (SCD) resulting in significant morbidity. Understanding associated risk factors can facilitate risk-based screening, earlier identification, and prompt intervention. Between 1998 and 2014, 26 symptomatic cases with imaging evidence of AVN were compared 1:5 with age- and SCD genotype-matched controls (n = 128). Patients with 1–5 vaso-occlusive crisis (VOC) (OR 11.9, 95% CI, 1.4–99.9; P = 0.02) and more than 5 VOC (OR 53.6, 95% CI, 5.5–520.2; P = 0.0006) in a 5-year period were more likely to have AVN. Symptomatic patients with more than five VOC in 5 years may benefit from radiologic screening for AVN.
Pediatric Blood and Cancer
Mesleh Shayeb, A., Smeltzer, M., Kaste, S., Brown, A., Estepp, J., & Nottage, K. (2018). Vaso-occlusive crisis as a predictor of symptomatic avascular necrosis in children with sickle cell disease. Pediatric Blood and Cancer, 65 (12) https://doi.org/10.1002/pbc.27435