Use this case to answer the following questions:
A 2-year-old black male was being evaluated at the County Clinic for swollen hands and feet that were extremely painful. Upon physical examination, the child was found to have a fever and hepatosplenomegaly, and was physically small for his age. The child was of Jamaican descent.
Patient history revealed that the child was normal for his birth weight, but since then, he was consistently underweight and undersized for his age group. Family history was not readily available. The physician had the child admitted to the hospital for workup and ordered the following CBC.
$\begin{array}{ll}
\text { TEST } & \text { RESULTS } \
\text { WBC } & 16.6 \times 10^{9} / \mathrm{L} \
\text { RBC } & 2.53 \times 10^{12} / \mathrm{L} \
\text { HGB } & 7.5 \mathrm{gm} / \mathrm{dL} \
\text { HCT } & 21.4 \% \
\text { MCV } & 84.6 \mathrm{fl} \
\text { MCH } & 18.9 \mathrm{pg} \
\text { MCHC } & 35.0 \mathrm{~g} / \mathrm{dL} \
\text { RDW } & 18.9 \
\text { PLT } & 511 \times 10^{9} / \mathrm{L}\
\text { Differential: }\
\text { Polys } & 84 \% \
\text { Stabs } & 10 \% \
\text { Lymphs } & 5 \% \
\text { Eos } & 1 \% \
\text { NRBCs } & 12
\end{array}$
-This patient presented with swollen hands and feet.What kind of crisis is this patient suffering from?

Question

Use this case to answer the following questions:
A 2-year-old black male was being evaluated at the County Clinic for swollen hands and feet that were extremely painful. Upon physical examination, the child was found to have a fever and hepatosplenomegaly, and was physically small for his age. The child was of Jamaican descent.
Patient history revealed that the child was normal for his birth weight, but since then, he was consistently underweight and undersized for his age group. Family history was not readily available. The physician had the child admitted to the hospital for workup and ordered the following CBC. 
 $\begin{array}{ll}
\text { TEST } & \text { RESULTS } \
\text { WBC } & 16.6 \times 10^{9} / \mathrm{L} \
\text { RBC } & 2.53 \times 10^{12} / \mathrm{L} \
\text { HGB } & 7.5 \mathrm{gm} / \mathrm{dL} \
\text { HCT } & 21.4 \% \
\text { MCV } & 84.6 \mathrm{fl} \
\text { MCH } & 18.9 \mathrm{pg} \
\text { MCHC } & 35.0 \mathrm{~g} / \mathrm{dL} \
\text { RDW } & 18.9 \
\text { PLT } & 511 \times 10^{9} / \mathrm{L}\
\text { Differential: }\
\text { Polys } & 84 \% \
\text { Stabs } & 10 \% \
\text { Lymphs } & 5 \% \
\text { Eos } & 1 \% \
\text { NRBCs } & 12
\end{array}$
-This patient presented with swollen hands and feet.What kind of crisis is this patient suffering from?

Quizplus · Accepted Answer

The patient is presenting with painful swollen hands and feet, which is likely due to vaso-occlusion, a common manifestation of sickle cell crisis in patients with sickle cell anemia. The patient's laboratory values also suggest sickle cell anemia, with a low hemoglobin and hematocrit, and an elevated white blood cell count with a left shift (more immature forms of white blood cells). The patient's Jamaican descent also puts him at higher risk for the disease. Therefore, the patient is likely suffering from a vaso-occlusive crisis related to sickle cell anemia. Oxidative crisis is not a recognized type of sickle cell crisis, and transfusion and anaphylactic reactions are less likely given the patient's clinical presentation and laboratory values.

Use This Case to Answer the Following Questions: a 2-Year-Old

Use This Case to Answer the Following Questions:
a 2-Year-Old