Pain is such a regular feature of sickle cell anemia that insome African languages the disease is referred to as "a stateof suffering." Biopsies in patients with severe acute bone painreveal that the underlying lesion is marrow necrosis with infiltrationof polymorphonuclear leukocytes.
To borrow an analogy from the heart, mild, brief, "anginal"episodes of pain reflect limited ischemia, and more severe episodesreflect infarction and necrosis. Although patients with eithermyocardial infarction or the severe pain of a sickle cell crisistypically require narcotic analgesia, there is no equivalentof nitroglycerin, thrombolysis, angioplasty, or bypass surgery. . . [Full Text of this Article]
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