Genetic and Rare Disease Information Center [GARD]. (2019). Psoriatic juvenile idiopathic arthritis. Retrieved from - juvenile-idiopathic-arthritis Goolsby, M. J. & Grubbs, L. (2014). Advanced assessment: Interpreting findings and formulating differential diagnoses , (3rd ed.). Philadelphia, PA: F. A. Davis Gozman, A. (2017). Pediatric splenomegaly clinical presentation. Retrieved from National Children’s Hospital. (2019). Circulation checks. Retrieved from - safety-resources/helping-hands/circulation-checks
National Heart, Lung and Blood Institute. (2018). Sickle cell disease. Retrieved from Replies Great post! Sickle cell anemia is an inherited form of anemia, a condition in which there aren't enough healthy red blood cells to carry adequate oxygen throughout your body. As you have highlighted the race of a child increases the risk of the disease. SCD mainly affects people whose families have origins from Africa and Hispanics whose families are from the Caribbean. Besides, having a family history of SCD increases a child’s risk for the disease. Most children with SCD mostly start to have symptoms during the first year of life, often around 5 months. Each child’s symptoms may vary. They may be mild or severe. The most severe symptoms include: Yellowing of the skin, eyes, and mouth (jaundice) (Nickel & Hsu, 2016). This is a common symptom and defined as scleral icterus as noted in Miah’s case. Acute complications associated with sickle cell among the pediatric population include infections, severe anemia, and vaso-occlusive phenomenon. More chronic complications can include severe pain, neurologic complications such as seizures, pulmonary impairment, renal complications, cardiomyopathy, and delayed puberty ( Vichinsky, 2017). Episodes of acute pain are one of the most common types of vaso- occlusive events in SCD and are responsible for a large number of patient encounters. While these episodes were previously called "sickle cell crises," the term “painful episodes” is now preferred because not all patients are in true crisis, and pain should not be allowed to progress to the point of crisis for patients to receive appropriate analgesia including opioid analgesics if indicated (Vichinsky, 2017). Pain episodes can begin as early as six months of age and typically last throughout life. In a series of children diagnosed with SCD at birth, one-third had experienced pain by the age of one year, two-thirds by the age of two years, and over 90 percent by the age of six (, 2017Vichinsky). Adequate pain management and hydration therapy have been shown to be the most effective treatment in pain episodes. Reference Nickle, R. S., & Hsu, L. L. (2016). Clinical Manifestations of Sickle Cell Anemia: Infants and Children. In Sickle Cell Anemia (pp. 213–239). Springer. doi: doi.org/10.1007/978-3-319- 06713-1_9 Vichinsky, E. P. (2017, November 9). Overview of the clinical manifestations of sickle cell disease. Retrieved from - manifestations-of-sickle-cell-disease?search=sickle cell
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