Pediatric Acute Liver Failure in Sickle Cell Disease

Introduction: Sickle cell intrahepatic cholestasis (SCIC) is one of the rarest and the most severe acute hepatic manifestations of sickle cell disease (SCD) and it can rapidly progress to acute liver failure. It is associated with a high mortality rate, demanding prompt recognition and management. Case Presentation: We report a case of a 7-year-old boy with a history of homozygous HbS SCD who presented to the emergency department with fever, increasing abdominal pain, and jaundice. His course was complicated by acute liver injury (AST 9,472 IU/L, ALT 2,683 IU/L, total bilirubin 15.4 mg/dL; conjugated bilirubin 8.69 mg/dL, hypoalbuminemia 2.6 g/dL, and persistent hypoglycemia), with acute liver failure (coagulopathy not corrected by vitamin K administration with INR 3.26, decreased factors V 10% and VII 28%, and West Haven grade I hepatic encephalopathy associated with mild hyperammonemia of 71 µmol/L). After excluding other causes of acute liver failure, the patient was diagnosed as having SCIC and was successfully treated with manual exchange transfusion. Conclusion: This case reinforces that exchange transfusion is an effective treatment for SCIC and that it should be introduced promptly to prevent fulminant and potentially fatal liver failure.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
Pediatric Acute Liver Failure in Sickle Cell Disease ; volume:29 ; number:3 ; year:2021 ; pages:192-196 ; extent:5
Portuguese journal of gastroenterology ; 29, Heft 3 (2021), 192-196 (gesamt 5)

Urheber
Rodrigues, Luís
Almeida, Sofia
Salgado, Catarina
Gonçalves, Cristina

DOI
10.1159/000515469
URN
urn:nbn:de:101:1-2022051900454677858288
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
15.08.2025, 07:32 MESZ

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Beteiligte

  • Rodrigues, Luís
  • Almeida, Sofia
  • Salgado, Catarina
  • Gonçalves, Cristina

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