Sickle Cell Anemia treatment
Patients with sickle cell disease need continuous treatment, even when they are not having a painful crisis. The goals of treating sickle cell anemia are to relieve pain, avoid infections, control symptoms and preventing complications. Although there is no cure for sickle cell anemia, doctors can do a great deal to help patients, and treatment is constantly being improved. In some cases, a bone marrow transplant can cure sickle cell anemia.
Early treatment of newborns includes penicillin prophylaxis, vaccination against pneumococcus bacteria and folic acid supplementation. Standard treamtents for complications of sickle cell anemia include antibiotics, pain management, intravenous fluids, blood transfusion, surgery, as well as bone marrow transplant.
Antibiotics. Children age 2 months to 5 year with sickle cell disease often receive daily antibiotics, such as penicillin, to prevent life-threatening infections, such as pneumonia. This practice stops at age 5 because older children don't have as many severe infections.
Pain management. During a sickle crisis, painful episodes are treated with pain-killing medicines and enough liquid intake. Fluids help prevent dehydration, a condition in which your body doesn't have enough fluids. Common medicines used to treat pain crises include acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and narcotics such as meperidine, morphine, oxycodone. Treatment of pain is critical. Non-narcotic medications may be effective, but some patients will require narcotics.
Hydroxyurea. It is a cancer medication for treatment of sickle cell anemia that reduces the frequency of pain epidsodes, acute chest syndrome and the need for blood transfusions in adults. Studies are currently underway to determine the proper dosage of hydroxyeurea for children. Researchers also are investigating similar drugs for children to reduce the number of complications and improve survival, as well as new approaches to gene therapy. Hydroxyurea can cause serious side effects, including an increased risk for dangerous infections. People who take hydroxyurea must be carefully watched.
Blood transfusions. It help benefit sickle cell disease patients by reducing recurrent pain crises, risk of stroke. Because red blood cells contain iron, and there is no natural way for the body to eliminate it, patients who receive repeated blood transfusions can accumulate iron in the body until it reaches toxic levels. It is important to remove excess iron from the body, because it can gather in the heart, liver, and other organs and may lead to organ damage. Treatments are available to eliminate iron overload.
Bone marrow transplant. This procedure allows people with sickle cell anemia to replace their bone marrow, and its sickle-shaped red blood cells with healthy bone marrow from a donor who doesn't have the disease. However, the procedure is risky and can lead to serious side effects or even death. Bone marrow transplants usually are used only for young patients who have severe sickle cell anemia, and bone marrow must come from a closely matched donor. This is usually a close family member who doesn't have sickle cell anemia.
Preventing and treating complications
Acute chest syndrome: it may develop after a painful event, and can be life-threatening. Early treatment is very important, they may include oxygen, pain medicines, antibiotics, and transfusions.
Eye damage: Patient with sickle cell disease should ask about regular checkups with an eye doctor who specializes in diseases of the retina every year.
Stroke: Starting at age 2, children who have sickle cell anemia often get routine ultrasound scans of their heads. These scans are used to check blood flow in the brain. The scans allow doctors to find out which children are at high risk for a stroke. These children are then treated with routine blood transfusions, which may reduce this risk.
Leg ulcers. Ulcers can be treated with cleansing solutions and medicated creams or ointments. Skin grafts may be needed if the condition continues. Bed rest and keeping the legs raised to reduce swelling are helpful.
Priapism. Treatment may include fluids (hydration), pain medicines, and blood transfusions by a urologist.
Today, many people with sickle cell anemia are in reasonably good health much of the time if they have good health care. Regular health maintenance is critical for people with sickle cell anemia. Good nutrition, good hygiene, good rest, protection against infections are important in maintaining good health and preventing complications. Regular visits to a physician or clinic that provides comprehensive care are necessary to identify early changes in the patient's health and ensure immediate treatment.