Sickle cell disease
Duke’s comprehensive sickle cell center is committed to providing the best diagnostic tools, treatment options and care for sickle cell disease. In addition to our extensive array of services and resources, we research new ways of treating the disease and its complications to provide the best care to our patients.
Comprehensive care to treat sickle cell disease
If you or a family member has sickle cell disease, a hereditary blood disorder characterized by abnormal red blood cells, you need a coordinated team to protect your health and prevent painful crisis and complications. With our highly trained doctors and wide-ranging resources, you can be sure you are getting the best care and most up-to-date treatments and services.
- A full range of patient services. We offer social services, psychological support and genetics counseling to provide for the complex needs of patients and their families. If you have sickle cell disease, you can count on us to address all of your disease-related issues.
- Benefit from a wealth of experts. Our highly trained specialists, including hematologists, obstetricians, neurologists, and orthopedic surgeons, offer a full array of resources and are skilled in working with sickle cell disease to provide you with the best care.
- Participate in clinical trials. We conduct studies supported by the National Institutes of Health and other organizations with the aim of discovering new treatments for sickle cell disease and its complications. You may be a candidate for an experimental therapy or research exploring one of the myriad problems encountered by patients with sickle cell disease.
- Access to community resources. We have cooperative ties with community sickle cell programs and also work closely with the N.C. Sickle Cell Syndrome Program. We can help you obtain support services, such as transportation to doctor visits and financial assistance, if needed.
- A wide array of educational resources. Our support team provides up-to-date materials to help you learn more about your condition and sponsor workshops, training programs, lectures and discussion groups. Our goal is to educate you about your condition and to encourage you to become active in your own care and make informed decisions about sickle cell screening and treatment.
SICKLE CELL DISEASE
Treatment for sickle cell disease is on-going and aimed at limiting your pain and the number of crises you experience.
In addition to pain medications, you may be prescribed hydroxyurea, which lessens anemia and reduces the number of crises, thus limiting the number of blood transfusions you may need. The high rate of red blood cell production associated with sickle cell disease requires significant amounts of folic acid, so you may be prescribed a supplement.
Sickle cell disease can cause you to become dehydrated. In addition to drinking plenty of fluids, you may need IV fluids.
You may require blood transfusions if you become severely anemic. Transfusions may also be needed to combat complications common to sickle cell disease, such as stroke or acute chest syndrome, a lung-related complication that can lower the levels of oxygen in the blood.
Hip or knee replacement surgery may be needed if your sickle cell disease causes the death of bone tissue due to a lack of blood flood. If you child has sickle cell, surgery to remove the spleen or gallbladder may be needed.
Duke is a leader in this treatment for sickle cell disease in both children and adults. Though risky, a bone marrow transplant, or stem cell transplantation, using blood marrow transplanted from a closely matched donor or stem cells derived from umbilical cord blood, may offer the chance for a cure.
Duke is at the forefront of hopeful research into gene therapy, which involves giving you a normal copy of the gene responsible for sickle cell disease to replace the faulty gene. Our doctors are also testing the effectiveness of new agents, such as nitric oxide, which causes the blood vessels to expand, and compounds that act like hydroxyurea to reduce the sickling of blood.
SICKLE CELL DISEASE
Duke specialists use these tests to both detect sickle cell disease, which causes red blood cells to become sticky and get stuck in blood vessels, and monitor your condition.
A simple blood test called hemoglobin electrophoresis can detect the presence of the abnormal hemoglobin that causes red blood cells to become shaped like sickles or crescents. The test uses an electric charge to differentiate between normal and abnormal types of hemoglobin. We also provide testing for the prenatal diagnosis of the disease, as well as testing for the ability of individuals to pass sickle cell and other blood disorders to their children.
If you have sickle cell disease, you need regular tests to determine the severity of your anemia and whether you are producing red blood cells appropriately. Your doctor will routinely assess your liver, kidney, heart and lung function and check for pulmonary hypertension. If you receive frequent transfusions, which raise iron levels, your iron will be checked regularly. Children with sickle cell disease, who have a higher than average risk for stroke, receive transcranial Doppler imaging, which is a painless test that uses ultrasound to measure blood flow in the head.