Sickle Cell Disease Clinical Trial
Official title:
Single-center Prospective Evaluation of Sickle Cell Patient Care in the CHU Brugmann Emergency Department
Sickle Cell Disease is a serious disease that is life-threatening for patients being
homozygous for the SS form or heterozygous for the SC or bthal forms. The CHU Brugmann
hospital currently regularly treats about 70 homozygous adult patients and this number is in
constant augmentation. The age average of the patients is below 30. The hospital developed a
close collaboration with the Queen Fabiola Kids University Hospital to optimize the
transition of young sickle cell patients from the pediatric to the adult network.
The emergency care of sickle cell patients remains a source of worry. Even with a correct
treatment (Hydroxy-urea or exsanguineous transfusions), patients suffer from frequent sickle
cell disease crisis when stress or infection cause hemolysis. The pain level is intolerable
and causes emergency hospital admission (2 to 3 crisis per patient per year on average). The
crisis are more frequent with poor compliance to the treatments.
There are several obstacles to the rapid and optimal management of these patients:
- fear of causing addiction to heavy pain releaf products (high dosis of morphine)
- lack of biological parameters for the determination of the crisis severity.
The prognostic value of the lactate dehydrogenase (LDH) level in a vaso-occlusive crisis was
recently stressed while activation of the coagulation, translated by the elevation of
various parameters including the rate of DD dimers, seemed associated with clinical
complications. The deleterious role of increased oxidative stress has also been recently
demonstrated in patients with sickle cell disease, opening new therapeutic avenues.
This study aims to prospectively evaluate the management of sickle cell patients being
admitted in the emergency department for a vaso-occlusive crisis. The level of satisfaction
of the patients will be measured.
The investigators will also evaluate the predictive value of several routine biological
parameters regarding the severity of the crisis, including the values of nitrous albumin
(PNA) as marker of oxydative stress. This last dosage will be made in collaboration with the
team of Dr Wayenberg and Pr Bottari in Grenoble.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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