RESUMEN
The diagnosis of deep vein thrombosis (DVT) is unusual in patients with sickle cell disease (SCD). Despite the incidence of cerebral thrombosis in SCD patients due to vasooclusion, thrombotic manifestations in peripheral vessels are rare. Patients with homozygous SCD present a variety of renal abnormalities as a result of sickle crisis. In this group of patients, kidney transplantation has been performed in the renal endstage patients; with graft survival rates similar to that of the general transplant population at 1 year. However, patients with SCD experience an augmentation in the frequency of painful crises in the first year after transplantation, which has been attributed to concurrent elevations in hematocrit and plasma viscosity. Despite etiology, renal transplant patients are at increased risk for the development of thromboembolic events such as deep vein thrombosis and renovascular thrombosis after allograft procedure. These events can be due to a prothrombotic state generated by the use of immunosuppressive agents. Although other factors such as acquired or inherited disorders of the clotting system may increase the risk of thrombosis. Here, we report a case of a renal transplant patient with sickle cell disease who presented recurrent episodes of DVT and increase painful sickle episodes after kidney transplantation.
Asunto(s)
Anemia de Células Falciformes/complicaciones , Trasplante de Riñón , Complicaciones Posoperatorias/etiología , Tromboflebitis/etiología , Adulto , Anticoagulantes/uso terapéutico , Heparina de Bajo-Peso-Molecular/uso terapéutico , Hepatitis C Crónica/complicaciones , Humanos , Inmunosupresores/uso terapéutico , Fallo Renal Crónico/etiología , Fallo Renal Crónico/cirugía , Masculino , Intercambio Plasmático , Complicaciones Posoperatorias/tratamiento farmacológico , Complicaciones Posoperatorias/prevención & control , Complicaciones Posoperatorias/terapia , Recurrencia , Trombofilia/tratamiento farmacológico , Trombofilia/etiología , Tromboflebitis/tratamiento farmacológico , Tromboflebitis/prevención & control , Tromboflebitis/terapiaRESUMEN
Os pacientes portadores de hemoglobinopatia S sofrem de uma anemia hemolítica crônica com repercussões sistêmicas. Estudo transversal retrospectivo com 64 pacientes portadores de hemoglobinopatia S, cujo objetivo foi descrever as suas manifestações clínicas. Com relação à gravidade clínica, 75,7 por cento dos portadores de anemia falciforme (SS) apresentaram doença grave, enquanto que 67,7 por cento dos portadores de traço falciforme (AS) apresentaram doença benigna, de acordo com os critérios de gravidade da doença. As alterações clínicas sistêmicas dos indivíduos portadores de hemoglobinopatia S estão presentes em algum momento de suas evoluções, sendo que o tipo e gravidade destas estão diretamente ligadas às variantes genéticas da doença