Role of Emergency Automated Red Cell Exchange in Sickle Cell Crisis: A Case Report

Abstract

For many years main stay of treatment for sickle cell anaemia was transfusion therapy. But repeated transfusions put the patient at risk of iron overload. Automated red cell exchange is an evolving and newer technique which rapidly removes the sickle cells and has benefit in decreasing sickle cell load and related complications. Red cell exchange is a therapeutic procedure in which the patient’s whole blood is processed centrifugally in cell separator. Patient’s red cells are separated from other blood components and removed and replaced with donor red cells and colloids. We report our first experience of automated red cell exchange in 24-year-old female diagnosed case of sickle cell anaemia presented to us with acute chest syndrome with septic shock. Red cell exchange was planned to tide over the acute sickle cell crisis and provide symptomatic improvement. We also highlight that compound heterozygous thalassaemia could be associated with sickle cell disease which could make the diagnosis difficult. New generation automated Apheresis equipment’s provides better monitoring of the procedure that can be useful in severely ill patients also.

A case report and review of literature on the role of automated red cell exchange in managing sickle cell crisis in India

“…detailed emergency RCE as a life-saving modality in managing a case of SCA with acute chest syndrome and sepsis in their manuscript. [ 21 ] An original article by Daniel et al . showcased automated RCEs as a safe and efficient therapeutic procedure for acute management of SCA before surgery to avoid complications.…”