Study of clinical profile of painful crisis in hospitalized children of sickle cell anemia

Background: To study the clinical profile of painful crisis in hospitalized children with Sickle cell anemia. Methods: A prospective cross sectional study; details of onset, perceived precipitating factors, associated symptoms, and pain distribution in the painful crisis have been studied in 195 painful crises in 130 patients of Sickle cell anemia. Results: The average age was 7.4±3.2 years with male preponderance predominantly from Mahar community (68.46%). Seasonal incidence was more during rainy season (99 patients). Of the perceived precipitating factors decreased oral intake (42.56%) and fever (54.36%) were common. Commonly involved joints were knee (39.18%), elbow (28.62%) and ankle joint (27.18%) while non-articular limb pain was experienced by 78.35% children. Bilateral limb and joint paint was seen in 82.64% and multiple site involvement (≥4 sites) was seen in 40%. Recurrence occurred in 28 patients but showed no significant evidence of involving same sites on successive occasions. Conclusions: Painful crisis were seen in 7-10 year old children with male preponderance, mainly from Mahar community, more during rainy season. Common precipitating factors were decreased oral intake and fever. Bilateral involvement was common. Duration of hospitalization was significantly longer in males than in females (3.47±1.7 Vs 3.86±2.51days) (p<0.01). Mean age (±) SD with spleen size (≥5 cm) was 8.48±1.92 years; indicating late persistence of splenomegaly.