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CC BY 4.0 · J Neuroanaesth Crit Care 2023; 10(01): 066-068
DOI: 10.1055/s-0042-1760273
Case Report

An Acromegalic Patient with Sickle Cell Disease Undergoing Endoscopic Trans-Sphenoidal Surgery: Anesthetic Concerns for a Neuroanesthesiologist

Priya Thappa
1   Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Research, Chandigarh, India
,
Nidhi B. Panda
1   Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Research, Chandigarh, India
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Abstract

Sickle cell disease (SCD) refers to a group of hemoglobinopathies that include mutations in the gene encoding the β subunit of hemoglobin. The glutamine in the heme portion of the hemoglobin molecule is abnormally substituted by valine. Sickle hemoglobin (hemoglobin type S), when gets deoxygenated, tends to polymerize and aggregate leading to vaso-occlusion and organ ischemia. Such patients are at increased risk of perioperative mortality and severe complications like vaso-occlusive crisis, acute chest syndrome, and congestive heart failure. We describe the perioperative management of a case of SCD with acromegaly scheduled for trans-sphenoidal removal of a functional pituitary adenoma. The acromegalic habitus, the cardiovascular effects of acromegaly, and the hormonal imbalances due to pituitary adenoma pose challenges in addition to the challenge of preventing complications of SCD making the anesthetic management more exigent.

Keywords

acromegaly - anesthesia - sickle cell disease


Publikationsverlauf

Artikel online veröffentlicht:
24. April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Blaisdell CJ, Goodman S, Clark K, Casella JF, Loughlin GM. Pulse oximetry is a poor predictor of hypoxemia in stable children with sickle cell disease. Arch Pediatr Adolesc Med 2000; 154 (09) 900-903
    CrossrefPubMedSuche in Google Scholar
  • 2 Adjepong KO, Otegbeye F, Adjepong YA. Perioperative management of sickle cell disease. Mediterr J Hematol Infect Dis 2018; 10 (01) e2018032
    CrossrefPubMedSuche in Google Scholar
  • 3 Yawn BP, Buchanan GR, Afenyi-Annan AN. et al. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members. JAMA 2014; 312 (10) 1033-1048
    CrossrefPubMedSuche in Google Scholar
  • 4 Howard J. Sickle cell disease: when and how to transfuse. Hematology (Am Soc Hematol Educ Program) 2016; 2016 (01) 625-631
    CrossrefPubMedSuche in Google Scholar
  • 5 Stein PD, Beemath A, Meyers FA, Skaf E, Olson RE. Deep venous thrombosis and pulmonary embolism in hospitalized patients with sickle cell disease. Am J Med 2006; 119 (10) 897.e7-897.e11
    CrossrefPubMedSuche in Google Scholar
  • 6 Terrell D, Savardekar AR, Whipple SG, Dossani RH, Spetzler RF, Sun H. Cerebral revascularization for moyamoya syndrome associated with sickle cell disease: a systematic review of the literature on the role of extracranial-intracranial bypass in treating neurologic manifestations of pediatric patients with sickle cell disease. World Neurosurg 2020; 137: 62-70
    CrossrefPubMedSuche in Google Scholar
  • 7 Sabbagh R, Kedar A. Increased prolactin level and pituitary adenoma as a cause of headache in two patients with sickle cell disease. Pediatr Hematol Oncol 1996; 13 (01) 101-105
    CrossrefPubMedSuche in Google Scholar
  • 8 Dahdaleh NS, Lindley TE, Kirby PA, Oya H, Howard III MA. A “neurosurgical crisis” of sickle cell disease. J Neurosurg Pediatr 2009; 4 (06) 532-535
    CrossrefPubMedSuche in Google Scholar
  • 9 Hariharan N, Brunson A, Mahajan A, Keegan THM, Wun T. Bleeding in patients with sickle cell disease: a population-based study. Blood Adv 2020; 4 (05) 793-802
    CrossrefPubMedSuche in Google Scholar