How I diagnose and treat venous thromboembolism in sickle cell disease.

Blood
Arun S Shet, Ted Wun

Abstract

The incidence of venous thromboembolism (VTE) in adult patients with sickle cell disease (SCD) is high. However, overlapping features between the clinical presentation of VTE and SCD complications and a low index of suspicion for thrombosis can influence patient management decisions. VTE in SCD can therefore present management challenges to the clinical hematologist. Herein, we present 3 distinct clinical vignettes that are representative of our clinical practice with SCD patients. These vignettes are discussed with specific reference to the hypercoagulable state in SCD patients, recent VTE diagnosis and anticoagulant therapy guidelines from the general population, and evaluation of the risk of bleeding as a result of long-term exposure to anticoagulant therapy. We examine current diagnostic and treatment options, highlight limitations of the existing clinical prognostic models that offer personalized guidance regarding the duration of anticoagulation, and propose a clinical approach to guide the decision to extend anticoagulation beyond 3 months.

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Citations

Sep 20, 2018·American Journal of Hematology·Chiara Dal ZottoLucia De Franceschi
Feb 19, 2019·Expert Review of Hematology·Foluso Joy OgunsileSophie Lanzkron
Sep 2, 2020·International Journal of Emergency Medicine·Omran Al DandanHind S Alsaif
Jul 30, 2020·International Journal of Molecular Sciences·Maria A Lizarralde-Iragorri, Arun S Shet
Aug 21, 2020·Haematologica·Arun S ShetRakhi P Naik
Nov 19, 2020·EFORT Open Reviews·Philippe HernigouCharles Henri Flouzat Lachaniette
Mar 7, 2020·Trends in Cardiovascular Medicine·Vandana SachdevSwee Lay Thein
Mar 5, 2021·Journal of Blood Medicine·Ugochi O OguPatricia Adams-Graves
Oct 16, 2020·Haematologica·Arun S ShetRakhi P Naik

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