Sickle-cell anemia is a multifactorial disease. Causes may be varied in different populations. Anemia is not well understood but it may be due to a variety of factors. It is important that physicians remain knowledgeable of sickle-cell diseases.
Overall, 9.5 million people are iron deficient, and 2.2 million persons carry an HH trait. These numbers are higher or lower than a number of available estimates of anemia in the U.S. population. Most estimates of anemia in the U.S. probably have underestimated the actual number of people affected and may not reflect the full range of disease in the U.S. population, or other nations.
Symptoms of anemia include tiredness, shortness of breath, pale or cyanotic complexion, chest pain, headache and dizziness.\n\nMany factors have been associated with risk for mental health problems. These can be grouped under 'environmental' or 'genetic' effects.\n\nThe 'environmental' factors include a range of external agents that may affect children's development. These include:\n- Childhood adversity: Exposure to a range of stressful life events in childhood such as maltreatment, violence or substance abuse have been associated with adverse effects on children's psychological adjustment.
Many different medications are used to treat anemia, including iron supplements that may improve the hem of sickle cell patients. There are also different medications used to improve the efficiency of sickle cell patients' red blood cells. One of the medications used to treat sickle cell anemia is hydroxycarbamide. The use of hydroxycarbamide, however, poses a rare and often severe medical risk for patients with sickle cell anemia. More study is required to determine the exact safe and effective drug choices in the treatment of this disease.
Anemia, sickle cell, is a significant cause of morbidity, mortality and resource utilization in children with sickle cell disease. The impact of anemia may be exacerbated by the fact that anemia screening is not done often. In areas where children do not receive regular screening, anemia is an important cause of illness and death. We urge all children with sickle cell disease to be screened for anemia.
Treatment of [sickle cell anemia](https://www.withpower.com/clinical-trials/sickle-cell-anemia) may help prevent death but cannot cure people with sickle cell anemia. The best approach for sickle cell crises is the prompt administration of broad-spectrum intravenous antibiotics. The choice of antibiotics is dictated by the severity and location of the infection. People with sickle cell anemia may benefit from oral antibiotics in the form of oral penicillins, cephalosporins, or imipenem/cilastatin. The combination of oral antibiotics and blood transfusion may be necessary until adequate transfusion is reached. Sickle cell crises can be prevented with the oral administration of hydroxycarbamide, which prevents sickle cell crises and improves survival of those with sickle cell disease.
There has been one study reporting the use of transfusion in children with [sickle cell anemia](https://www.withpower.com/clinical-trials/sickle-cell-anemia). A study involving the administration of hydroxycarbamide in children with sickle cell anemia has been completed; however, study results are not yet available. The study should have included a control group of infants who do not have sickle cell anemia: in this manner, the effect of the drug on the natural history of sickle cell should be determined. A study of children with sickle cell anemia treated with folic acid is currently ongoing.
There exists a shortage of funding for testing of new drugs to fight anemia and sickle cell disease. In an attempt to fill that lack, it has been proposed that one of the greatest scientific opportunities is the screening of drugs against sickle cell disease.
The findings provide some evidence that anemia may run in families; however, because the present results may have been obtained using self-report surveys, future confirmation by using questionnaires or objective measures of hemoglobin levels and iron status is warranted before using this result as a genetic marker for familial cases of anemia.
In the United States children and adolescents with anemia are not routinely screened for sickle cell trait or disease, a condition that increases risk for adverse cardiovascular outcomes. Patients with anemia and sickle cell disorders should be screened for an abnormal hemoglobin profile, which allows for the detection of sickle cell anemia.
The quality of life for those with SFA-L is affected by the occurrence of an acute vaso-occlusive crisis in addition to chronic anemia. These effects tend to regress within four weeks from the initiation of treatment. The occurrence of these clinical events may be due to the persistence of autoantibodies produced by the immune system to sickle cell protein or may be caused by an inability to adequately clear or metabolize the excess sickle cell protein from the circulatory system and other organs and tissues.
In the past 30 years, the number of patients who have been receiving regular intravenous infusions of iron has increased sharply. The primary reason for this can be traced back only a few years to a review published in 1980, where it was noted that the majority of patients who were receiving routine iron as the only treatment for chronic iron deficiency were black, and that blacks often require more iron than whites. Since then, the proportion of blacks receiving regular iron infusions has continued to increase. In the United States, white patients have a substantially higher prevalence of iron-deficiency anemia than blacks during the same period.