Types of crises in sickle cell disease patients presenting at the haematology day care unit (HDCU), University College Hospital (UCH), Ibadan.

OBJECTIVE: The aim of the study was to determine the types of crises in Sickle Cell Disease (SCD) patients seen at the Haematology Day Care Unit (HDCU) of the University College Hospital (UCH), Ibadan.

MATERIAL AND METHODS: The study is a retrospective survey using the registers of all patients seen in the year 2001 (January-December). Data extracted included demographic parameters, types of crises, haematocrit level and outcome of treatment received. The patients studied were both HbSS and HbSC in crises.

RESULT: There were five hundred and eight HbSS and thirty seven HbSC patients seen during the survey period. Vaso-occlusive crisis had the highest prevalence of 91.6%, while haemolytic crisis had the least (0.5%). More females (56.7%) had crises than males (43.3%) in the vaso-occlusive group. The relationship between crises type and sex was not significant (p = 0.282). Young adults (20-29 years) had more crises (49.9%) than other age groups but crises were rare in children (0.2%). There was, however, a significant relationship between age group and crises type (p < 0.00). Eighty one percent of the subjects had PCV > 20%. The type of crisis is related significantly to the treatment received (p < 0.000). Fifty six percent of the subjects required analgesics alone while was admitted for blood transfusion and other medical, surgical, gynaecological and obstetric complications. There was only 1 (0.1%) recorded death within the 12 month survey period in a 31 year-old HbSC female who had painful and haemolytic crisis.

CONCLUSION: There were six types of crises seen in the sickle cell disease subjects namely vaso-occlusive, sequestration, infarctive, aplastic, haemolytic and bone pain crises. Vaso-occlusive crisis was the most common and haemolytic crises the least. Vaso-occlusive crisis was more common among young adults (20-29 year age group). The mortality rate was found to be 0.1%.