Which of the following statements regarding the long-term complications of sickle cell disease is the most informative for the given-below patient?
A 21-year-old African-American woman with sickle cell anemia returns to your office to discuss the course of her disease. She is most concerned about the risks associated with pregnancy but would like to discuss all of the long-term complications of her disease.
1. Arthroplasty is the recommended treatment for severe aseptic necrosis of the femoral head. B. Patients are at an increased risk for osteomyelitis with Escherichia coli because of deficiencies in serum opsonization. C. Cholelithiasis is a frequent side effect of sickle cell disease. D. Leg ulcers are an important cause of morbidity and correlate with the degree of anemia.
Cholelithiasis is a frequent side effect of sickle cell disease.-aseptic necrosis (osteonecrosis) of the femoral head occurs in about 10% of patients, particularly those who also have a thalassemia. arthroplasty has been relatively ineffective, partly because of the presence of adjacent hard bone, which interferes with the placement of the prosthesis, and because of the increased risk of infection. patients with sickle cell anemia are hyposplenic and exhibit complement system abnormalities. deficient serum opsonizing activity for salmonella organisms may confer an increased susceptibility to those infections, including osteomyelitis. cholelithiasis occurs in 30 to 70% of patients, some of whom exhibit signs and symptoms of cholecystitis. there are conflicting data regarding the frequency of cholecystitis or obstruction of the common bile duct. if cholecystectomy is to be done, one should wait until the painful crisis is over. poorly healing leg ulcers can be an important cause of morbidity in patients with sickle cell anemia. the degree of anemia does not seem to correlate with the presence or severity of these ulcers, but incompetence of venous valves and the resulting venous insufficiency have been associated with ulceration.