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AnemiaVolume 2011 2011, Article ID 975731, 3 pages

Case ReportHematology Division and Center for Cell Based Therapy, Department of Internal Medicine, Medical School of Ribeirao Preto, University of Sao Paulo, 14051-140 Ribeirao Preto, SP, Brazil

Received 27 September 2010; Accepted 23 November 2010

Academic Editor: Ajit C. Gorakshakar

Copyright © 2011 Denise Menezes Brunetta et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Intrahepatic cholestasis SCIC is an uncommon but potentially fatal complication of sickle cell disease SCD, with a high death rate, observed mainly in patients with homozygous sickle cell anemia. Herein, we describe a case of severe SCIC treated successfully with aggressive manual exchange transfusion ET. The patient was admitted with enlarged liver and signs of hepatic failure, such as hyperbilirubinemia and coagulopathy. There was no evidence of viral hepatitis or biliary obstruction. We performed several sessions of ET in order to reduce the percentage of HbS to levels inferior to 30%, which was successfully accomplished. The patient had a complete recovery of hepatic function. This case has shown that ET is an effective treatment of SCIC and should be introduced early on the onset of this severe complication.

Autor: Denise Menezes Brunetta, Ana Cristina Silva-Pinto, Maria do Carmo Favarin de Macedo, Sarah Cristina Bassi, Joao Victor Piccolo



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