CASE PRESENTATION ON sickle cell anemia new.pptx

Sickle cell anemia

1. CASE PRESENTATION DR. SONA SONI (ASSO. PROFESSOR )


PRESENTED BY: DR RIYA (III YR )
DR PRAGYA S (II YR )

2. Patient details NAME : VARSHA
AGE : 21 YEARS
SEX: FEMALE
ADDRESS: VILLAGE TARASEN SHAHPUR BETUL 7247441835
RELIGION : HINDU
EDUCATION STATUS: 12 TH STD
OCCUPATION: HOUSE WIFE
MARRITAL STATUS: MARREID

3. HUSBAND
OCCUPATION : MECHANIC
EDUCATIONAL STATUS: Graduate
PARITY : PRIMIGRAVIDA
SOCIOECONOMIC STATUS: LOWER MIDDLE CLASS (MODIFIED KUPPUSWAMY SCALE)
DATE OF ADMISSION : 15/02/2025

4. PATIENT WAS REFFERED FROM DH BETUL ON 15/02/2025 AT 03:20 PM I/V/O ANC WITH PRETERM WITH SEVERE ANEMIA WITH RAISED BILIRUBIN WITH SEVERE PAIN WITH SICKLE CELL TRAIT A 21 YEAR FEMALE PRESENTED ON 15/02/25 AT 12:40 PM PATIENT C/O B/L KNEE JOINT PAIN SINCE 2 DAYS FOR WHICH SHE WENT TO DH BETUL WHERE SHE WAS ADMITTED FOR 1 DAY NO C/O PAIN IN ABDOMEN LEAKING OR BLEEDING P/V NO H/O HTN / DM / THYROID / TB ANY OTHER CHRONIC MEDICAL OR SURGICAL ILLNESS NO H/O DENGUE/ MALARIA / CHICKEN GUNYA / TYPHOID K/C/O SICKEL CELL TRAIT H/O 3 UNIT PRC TRANSFUSION IN DECEMBER 2024 NO H/O FCM TRANSFUSION RECEIVED 2 DOSES OF TT VACCINATION 14/02/2025- SICKLING TEST NEGATIVE CHIEF COMPLAINTS

5. PRIMIGRAVIDA LMP - 28/06/2024 AMENORRHEA SINCE 8 MONTHS C/O PAIN IN B/L LOWER LIMB SINCE 2 DAYS C/O BREATHLESSNESS SINCE 2 DAYS NO C/O ORTHOPNOEA NO C/O ANY FAINTING EPISODE NO C/O DIZZINESS NO C/O PAIN IN ABDOMEN BLEEDING OR LEAKING P/V HOPI

6. ON EXAMINATION GC- AVERAGE TEMP – AFEBRILE PALLOR + PR- 90/MIN ICTERUS – BP – 120/80 EDEMA - SPO2- 97% P/A – UT 34 WEEK SIZE CEPHALIC RELAXED FHS +/REG/138 BPM P/V – OS CLOSED CERVIX UNEFFACED

7. USG ABDOMEN– 15/02/2025 SPLEEN APPEARS ENLARGED IN SIZE APPROX 12.5 CM WITH ALTERED ECHOTEXTURE OF SPLEENIC PARENCHYMA NOTED WITH WELL DEFINED HETROGENOUS HYPOECHOIC LESIONS NOTED IN MID AND LOWER POLE OF SPLEEN LARGEST OF SIZE 18 X 21 MM IN MID POLE SHOWING INTRALESIONAL VASCULARITY ON COLOR FLOW LIKELY BENIGN ETIOLOGY S/O ? SPLEENIC HEMANGIOMA REST FINDINGS ARE WNL

8. USG PELVIS – 18/02/2025 SINGLE LIVE INTRAUTERINE FETUS OF MGA – 31 WEEKS PLUS 3 DAYS CEPHALIC PRESENTATION PLACENTA – POSTERIOR ( GRADE 2) AFI – ADEQUATE EFW- 1640 GM E/O SINGLE LOOP OF CORD AROUND NECK

9. HPLC – 16/02/2025 ELECTROPHORESIS HAEMOGLOGLOBIN (HB) HBA 6.6 % 95-98 HBA2 1.8 % 1.5-3.7 HBF 22.0 0-2 HBS 69.6% 0-0.02 HB 6.6 G/DL RBC 1.89 X 10^6 3.8-4.8 MCV 107.41 83-101 MCH 34.92 27-32 RDW 16.1 11.5-14.5 S/O SICKLE CELL DISEASE

10. INVESTIGATIONS- 18/02/2025 BLOOD GROUP – A+ 16/02/2025 18/02/2025 20/02/2025 HB 7.1 GM/DL 6.2 GM/DL 6.7 GM/DL WBC 16000 19000 17000 PLATELET 2.31 LACS 2.28LACS/CUMM 1.23 LACS RBC 1.82 1.59 1.77 X10^6 INR 1.40 TSH 4.16 T BIL 4.90 2.10 6.6 MG/DL D BIL 1.50 0.70 1.6 MG/DL SGOT/PT 54/12 37/10 57/10 SR CREAT 0.60 0.50 0.60 VIT B12 188.83 S VIT D 18.06 S FOLATE 23.9 S FE 86.70

11. MANAGEMENT EXPLAIN RISK MAINTAIN HYDRATION PRC TRANSFUSION INTERMITTENT OXYGENATION TAB UDILIV 300 MG BD TAB HYDROXYUREA 500 MG OD MEDICINE REFERENCE HEMATOLOGY REFERENCE DFMC LLP W/F/VITALS/FHS

12. RISK FACTORS

13. PROVISIONAL DIAGNOSIS PRIMIGRAVIDA 34 WEEK 1 DAY PREGNANCY WITH SICKLE CELL CRISES WITH JAUNDICE WITH SEVERE ANEMIA

14. Thank you