RESUMEN
Background Sickle cell disease (SCD) is a common hematological disorder with a high prevalence in Saudi Arabia. Despite that, limited studies are available in our region regarding cardiovascular complications. Objectives The objective of the current study was to estimate the prevalence of cardiovascular complications among children with SCD. Design This was a cross-sectional study. Setting The study took place at a single tertiary-care center in Jeddah, Saudi Arabia. Materials and methods The study reviewed 126 electronic records of pediatric patients up to 16 years old diagnosed with SCD between January 2008 and December 2019 in King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Of these, 54 patients had a previous echocardiogram evaluation and were eligible for the study. Main outcomes measures The study identified cardiovascular complications in pediatric sickle cell patients. Sample size The study included a total of 54 pediatric sickle cell patients. Results The mean age was 11.9 (3.48) years, the male-to-female ratio was 2:1, the majority (94.4%) had the HbSS-HbSß0 genotype, the mean baseline hemoglobin F (fetal hemoglobin) was 20.30 (9.03%), and the clinical severity score was severe in 19 (35.2%) and mild/moderate in 35 (64.8%) patients. Cardiovascular complications occurred in 32 (59.3%) patients. Increased systolic blood pressure was detected in 10 (18.5%) patients. Echocardiography showed left ventricular dilatation in nine (16.7%) patients, tricuspid valve insufficiency in six (11.1%) patients, mitral valve insufficiency in four (7.4%) patients, hyperdynamic left ventricle in one (1.9%) patient, and pulmonary hypertension in one (1.9%) patient. Long QTc interval was noticed in three (5.6%) and cardiomegaly was detected in 18 (33.3%) patients. Conclusion Cardiovascular complications occurred at a high frequency in our pediatric population despite high baseline hemoglobin F levels. Early evaluation and continuous monitoring are important for early intervention.
RESUMEN
A 30-year-old Pakistani construction worker, not known to have any chronic medical illnesses, presented to the emergency room with a history of ingesting two cups of cement diluted in water, seven hours prior to the presentation, in addition to a cut on his left wrist using a sharp piece of ceramic. He was conscious, oriented, and vitally stable. Physical examination was unremarkable except for epigastric hardness and tenderness. Treatment upon admission included escitalopram 10 mg and haloperidol 5 mg. Upper GI endoscopy showed large, hard cement in the stomach and multiple pre-antral erosions. The patient was started on omeprazole 40 mg after the procedure. Exploratory laparotomy and gastrotomy were performed as well. The procedure showed a foreign body, gypsum, occupying the stomach and extending from the fundus to the pylorus. Multiple small foreign bodies were seen in the rectum. The foreign bodies were extracted completely. Before discharge, a suicide risk assessment was done using the modified SAD PERSONS scale. The patient's total score was 5, which is low risk. The patient received psychiatric care, and his post-discharge follow-up was unremarkable.
