Department of Biochemistry
University of Jos
Sickle cell disease history video
Mr X Michael, 21 year old undergraduate studying Geography at the University of Jos.
He is Berom by tribe and was born in Jos 21 years ago.
History of Presenting complaint
The patient is a known sickler and this as diagnosed 6 months after birth when the mother took him to hospital because he developed fever and painful and swollen knuckles. Since then he has been having illnesses especially during the rainy seasons which included cough, fever and pains in the body and joints. This present illness started two days ago when he developed fever, pains in the joints and yellow eyes together with severe pains in the chest yesterday. He has been given chloroquine tablets (4) but this has not assisted or made his pains less. His breathing has become labored since yesterday and very fast. He now complains of pains in the chest, back and left leg.
He is the first child of his parents who met 22 years ago in this Jos. The mother hails from Oturkpo in Benue State of Nigeria while the Father is from Berom. The parents have no history of sickle cell disease in their families.
GIT- He has no problems with eating and defecating, but sometimes, especially when he has fever, looses his appetite.
He was found to be pale and jaundiced by examination of the conjunctival mucous membranes. He was not dehydrated and there is no evidence of subcutaneous edema. He is 6 feet tall and his weight is 21 kilograms.
On examination of the abdomen, the liver is moderately enlarged at a level of 2cm below the costal margin but the spleen and kidneys were not palpable. There were no tenderness in the abdomen. Normal bowel sounds are heard.
RBC- 2.2 x106/ml (4.6-6.2x106)
WBC- Total- 4,500/ cumm; Diff- N-71%, L 20%, M-5%,E-3% B-1%
Platelet- 300,000/cu.mm (290,000-140,000)
Hemoglobin 9 gm/dl (13.5-18.0)
Morphology - Sickle cells
ESR 75mm/hr (<15)
Serum Iron- 70 µg/dl (50-150)
Iron binding capacity- 300 µg/dl (250-450)
Serum Ferritin 100 µg/dl (10-270 µg/dl)
Electrolyte and Urea
Serum carbon dioxide content 40 mmols/l (24-30)
Bilurubin Total - 3 mg/dl (0.1-1.2)
Conjugated 0.27 mg/dl (up to 0.3mg/dl)
Diagnosis: HbSS disease; Sickle cell anemia, Hb SS disease with bone pain crisis and acute chest syndrome.
Electronic School of Medicine
Creator: Oluwole Ogunranti