A 7-year-old boy with sickle cell disease presents with acute chest pain, fever, and cough. Chest X-ray shows a new infiltrate. All of the following are recognized complications of sickle cell disease EXCEPT:

Question

Accepted Answer

A. Proliferative diabetic retinopathy as the most common ocular complication. ## Complications of Sickle Cell Disease

### Acute Chest Syndrome (ACS)

**Key Point:** ACS is a life-threatening complication characterized by chest pain, fever, cough, and new pulmonary infiltrates. It results from pulmonary infarction (due to vaso-occlusion), infection (pneumonia), or fat embolism from bone marrow infarction. It is a leading cause of death in sickle cell disease.

### Splenic Sequestration Crisis

**High-Yield:** Splenic sequestration occurs when sickled RBCs are trapped in the spleen, causing rapid splenomegaly, acute anemia, thrombocytopenia, and hypovolemic shock. This is a medical emergency requiring urgent transfusion. It typically occurs in children under 5 years and is rare in adults (due to autoinfarction of the spleen).

### Osteomyelitis in Sickle Cell Disease

**Clinical Pearl:** Patients with sickle cell disease have a 50-fold increased risk of osteomyelitis. Salmonella species are the most common causative organisms (unlike the general population where Staphylococcus aureus predominates). This is a classic association tested in NEET PG.

**Mnemonic:** SALMONELLA in SICKLE CELL — both start with 'S'.

### Ocular Complications

**Warning:** The most common ocular complication of sickle cell disease is **proliferative sickle retinopathy** (not diabetic retinopathy). Proliferative sickle retinopathy results from retinal vaso-occlusion and neovascularization, leading to "sea fan" neovascularization and potential retinal detachment. Diabetic retinopathy is a complication of diabetes mellitus, not sickle cell disease.

| Complication | Mechanism | Clinical Feature |
| --- | --- | --- |
| Acute chest syndrome | Pulmonary infarction ± infection | Chest pain, fever, infiltrate |
| Splenic sequestration | RBC trapping in spleen | Acute anemia, splenomegaly, shock |
| Osteomyelitis | Salmonella (classically) | Bone pain, fever |
| Proliferative retinopathy | Retinal vaso-occlusion | Sea fan neovascularization |
| Diabetic retinopathy | Hyperglycemia (diabetes) | NOT a sickle cell complication |

**High-Yield:** Proliferative sickle retinopathy, not diabetic retinopathy, is the characteristic ocular finding in sickle cell disease.

Answer

B. Acute chest syndrome with pulmonary infarction and/or infection

Answer

C. Osteomyelitis predominantly caused by Salmonella species

Answer

D. Splenic sequestration crisis with rapid splenomegaly and hypovolemic shock

A 7-year-old boy with sickle cell disease presents with acute chest pain, fever, and cough. Chest X-ray shows a new infiltrate. All of the following are recognized complications of sickle cell disease EXCEPT:

Explanation

Complications of Sickle Cell Disease

Acute Chest Syndrome (ACS)

Splenic Sequestration Crisis

Osteomyelitis in Sickle Cell Disease

Ocular Complications

Practice similar questions

Join our NEET PG community

Complication	Mechanism	Clinical Feature
Acute chest syndrome	Pulmonary infarction ± infection	Chest pain, fever, infiltrate
Splenic sequestration	RBC trapping in spleen	Acute anemia, splenomegaly, shock
Osteomyelitis	Salmonella (classically)	Bone pain, fever
Proliferative retinopathy	Retinal vaso-occlusion	Sea fan neovascularization
Diabetic retinopathy	Hyperglycemia (diabetes)	NOT a sickle cell complication