A seven years old Saudi girl is known as a case of SCA. She presented to the emergency department with a history of fever for five days and jaundice with abdominal pain and mild respiratory distress. Also, she was complaining of left elbow pain for the preceding three days.
On examination, the patient was looking unwell, deeply jaundiced, highly febrile, with tachycardia and tachypnea. Blood pressure was normal. Chest examination revealed bilateral crepitation with bronchial breath at the base of lungs bilaterally. Cardiovascular system examination was normal. The abdomen was soft and lax with tender hepatomegaly while the spleen was just palpable. The left elbow was swollen with hotness and tenderness. No neurological deficits had been detected.
Initial workup showed :Hemoglobin: 7.5 g/dl, Mean Corpuscular Volume (MCV): 76 fL, White Blood Cells (WBC): 24 10^9/L, Platelets: 335 10^9/L, Prothrombin Time: 13 s., Partial Thrombotic Time: 33 s., Total Bilirubin (TB): 535 UMOL/L, Direct Bilirubin (DB): 434 UMOL/L, albumin: 24 G/L. Erythrocyte Sediment Ratio (ESR): 33 mm/hr. C-reactive protein (CRP):0.45. Chest X-ray revealed increased bronchovascular marking with bilateral basal lung opacities.