Hematology and Oncology Book

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Hand Foot Syndrome in Sickle Cell Anemia

Aka: Hand Foot Syndrome in Sickle Cell Anemia, Dactylitis in Sickle Cell Anemia
  1. See Also
    1. Sickle Cell Anemia
    2. Transient Red Cell Aplasia
    3. Acute Chest Syndrome
    4. Acute Vaso-Occlusive Episode in Sickle Cell Anemia
    5. Aplastic Crisis in Sickle Cell Anemia
    6. Cerebrovascular Accident in Sickle Cell Anemia
    7. Hematuria in Sickle Cell Anemia
    8. Osteomyelitis in Sickle Cell Anemia
    9. Priapism in Sickle Cell Anemia
    10. Pulmonary Hypertension in Sickle Cell Anemia
    11. Septic Arthritis in Sickle Cell Anemia
    12. Sickle Cell Anemia Related Pulmonary Hypertension
    13. Sickle Cell Anemia with Splenic Sequestration
  2. Epidemiology
    1. Often the first vaso-Occlusion crisis finding in young children (as early as 6 months of age)
    2. Occurs in up to 50% of children with Sickle Cell Anemia by the age of 2 years
    3. Rare over age 4 years old
  3. Pathophysiology
    1. Not to be confused with Hand Foot Syndrome that occurs with certain Chemotherapy agents in non-sickle disease
    2. Occurs in Sickle Cell Anemia with vaso-Occlusion
    3. Caused by infarction of Bone Marrow
      1. Metacarpal or Metatarsal Bones and phalanges
  4. Symptoms
    1. Painful swelling and tenderness of either the hand or foot
    2. Digits may appear mildly erythematous
  5. Signs
    1. Low grade fever (variably present)
  6. Differential Diagnosis
    1. Osteomyelitis (Salmonella)
  7. Course
    1. Resolves spontaneously within 1 week
  8. References
    1. Welsh and Welsh (2016) Crit Dec Emerg Med 30(11): 15-23

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