Grace I., 7

Grace is a 7yo female child currently staying with her parents. She is the third child among three children. She makes the whole family happy as she is the first female child. Her father works at the village local government as a simple secretary earning salary of only 25,000, and the mother is a housewife. They are struggling to take care of the children and the home because the pay the father gets is nothing satisfying. They live in a 2-room apartment in his family home. They make use of water from the well for their daily activities; they have access to electricity. Patient’s illness started three days ago with sudden crying which made the mother to suspect abdominal pain. Initially the crying was intermittent and mostly at night but last night she cried throughout the night. She is said to have had fever two weeks ago, there’s associated rise in body temperature which came down with the administration of paracetamol tabs. She also has runny nose (colorless discharge). Patient was diagnosed of sickle cell diseases three years ago, she eventually developed (R) hemiparesis three years ago and lost her speech two years back. The parents don't have the money to pay for the medical bills that is why they reached out to Helpster Charity for the support. On presentation at our hospital, she was evaluated and diagnosed to have Vasooccluisve crisis (Bone crisis) of Sickle cell disease.

Grace’s illness started three days ago with sudden crying which made the mother to suspect abdominal pain. Initially the crying was intermittent and mostly at night but last night she cried throughout the night. She is said to have had fever two weeks ago, there’s associated rise in body temperature which came down with the administration of paracetamol tabs. She also has runny nose (colorless discharge). Patient was diagnosed of sickle cell diseases three years after birth, she eventually developed (R) hemiparesis a year after and lost her speech two years back. She was admitted and treatment with injection antimalarials, injection antibiotics and other supportive care was given. Patient did well after hospital stay. She stopped the continued night cry, fever stopped and was eventually discharged. Some drugs was given for continuing treatment at home.

Grace is having sickle cell crisis of Vaso-occlusion which causing bone pains and negatively impairing her quality of life. The prognosis of bone crisis (vaso-occlusive crisis) in sickle cell disease is generally good with early and appropriate management. Most episodes resolve within a few days with adequate analgesia, hydration, rest, and treatment of triggering factors such as infection. However, recurrent or severe crises can lead to complications including avascular necrosis, chronic pain, bone infarction, and reduced quality of life. Prognosis is poorer in patients with frequent crises, delayed presentation, poor access to care, or coexisting infections. Long-term outcomes improve with preventive measures such as hydration, infection control, and disease-modifying therapy like hydroxyurea.