Sudden death in a patient newly diagnosed with diabetes having hyperosmolar non-ketotic acidosis with sickle cell trait

Biedrzycki, Olaf J.; Gillespie, H. K.; Lucas, S

doi:10.1136/jcp.2005.028407

Cited by 10 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The presence of HbA attenuates HbS phenotype, reducing the probability of polymer formation; hence, normal hematological parameters are observed in the majority of individuals with sickle cell trait 54 . Nevertheless, cumulative evidence suggests that hypoxia may trigger sickle‐related complications such as splenic infarction, thromboembolism, papillary necrosis, exertional rhabdomyolysis, and death in sickle cell trait 26,31‐40,43,44 …”

Section: Epidemiology and Molecular Pathogenesis Of Sickle Cell Traitmentioning

confidence: 99%

“…Being the carrier state for an autosomal recessive genetic disorder, sickle cell trait is frequently perceived to be a relatively benign condition; however, this remains controversial 26‐30 . Conditions of increased oxygen demands may trigger sickle‐related complications in heterozygotes 31‐44 . COVID‐19 causes severe pneumonia in at‐risk individuals resulting in an increased oxygen demand.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sickle cell trait and the potential risk of severe coronavirus disease 2019—A mini‐review

Kehinde

Osundiji

2020

European J of Haematology

View full text Add to dashboard Cite

Following the emergence of Coronavirus Disease 2019 (COVID-19) in Wuhan (China) around December 2019, 1 the infection has become a pandemic, decimating over three hundred thousand globally. 2 The severity of COVID-19 cases reported hitherto has varied greatly from asymptomatic to severe pneumonia and thromboembolism, accompanied by overt respiratory failure with subsequent mortality. 3-5 As the COVID-19 pandemic continues to evolve, potential risk factors that may predispose individuals to fatal outcomes are increasingly becoming topical. There are ongoing epidemiological investigations and discussions of potentially at-risk populations and ethnicities. 6,7 An improved understanding of the risk factors as well as clinical course for severe COVID-19 may shed some light on novel personalized approaches to optimize clinical care and outcomes. Emerging trends in the United States suggest possibly higher mortality rates of COVID-19 among African Americans, 8,9 although epidemiological study data with adequate denominator 10 across board is pending. There is no doubt that socioeconomic determinants of health play crucial roles in health inequities and disease trajectory. 11 Nevertheless, interplay of genetic and environmental factors contributes to overall clinical outcomes in a substantial burden of human diseases. 12-17 Sickle cell disease (SCD) disproportionately affects Black/ African Americans in the United States as well as forebearers from sub-Saharan Africa, the Western Hemisphere (South America, the Caribbean, and Central America), and some Mediterranean countries. 18-20 Increasing evidence suggests that COVID-19 pneumonia can cause acute chest syndrome (ACS), a potentially life-threatening complication in SCD. 21-23 These observations raise questions on the potential contributions of SCD-related complications, for instance

show abstract

Section: Epidemiology and Molecular Pathogenesis Of Sickle Cell Traitmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sickle cell trait and the potential risk of severe coronavirus disease 2019—A mini‐review

Kehinde

Osundiji

2020

European J of Haematology

View full text Add to dashboard Cite

show abstract

“…Patients with SCT are not rare in the UK, 3 and the popularity of dieting in modern society is clear.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, however, increasing numbers of reports have stressed the potential for this group of patients to die suddenly and unexpectedly under circumstances of physiological stress. 3 A review of the risk of sudden death among soldiers with SCT, when compared with their hemoglobin AA counterparts, 4 showed a 28-to 40-fold increased risk of sudden unexplained death during exertion, and the importance of identifying people with undiagnosed SCT is well known in certain situations such as sports medicine, professional divers, and military aircrew. 5 To add to the paucity of published reports concerning sudden death in SCT, we would like to add a novel scenario of the sudden death of a previously fit and well 29-year-old black woman during a period of strict religious fasting.…”

mentioning

confidence: 99%

Sudden Death During Prolonged Religious Fasting

Biedrzycki

Sheaff²

2010

American Journal of Forensic Medicine &Amp; Pathology

View full text Add to dashboard Cite

Sickle cell trait (SCT) is estimated to occur in 6% to 10% of Africans, and the United Kingdom (UK) prevalence rate has been estimated at 3.2%. Although sudden death in sickle cell disease is well known, its occurrence in SCT is rare and requires extremes of physiological stress. We present a case of a 29-year-old black woman who died suddenly during a period of religious fasting. Her medical history was unremarkable, and there was no family history of sickle cell disease. At postmortem, she was found to be dehydrated, and macroscopically, the main abnormal findings were congested lungs and a small spleen. Histological examination revealed extensive vascular congestion with red blood cell sickling in both lungs, the liver, and the spleen. Electrophoresis on a postmortem blood sample confirmed the clinical suspicion that the patient was a carrier of SCT. The case highlights a novel scenario of SCT associated sudden death. We discuss the potential pathophysiological mechanisms that may have led to the patient's demise. We also remind pathologists to consider this diagnosis as potentially contributing to the cause of death in apparently fit young people of ethnic origin during episodes of physiological stress.

show abstract

“…associated with natural disease could initiate fatal sickling in these patients. For example, one patient with SCT reportedly developed fatal sickling in a setting of hypertension and end‐stage renal disease , and dehydration, hypoxia, and acidosis were believed to result in fatal sickling in another SCT patient with newly diagnosed diabetes and hyperosmolar, nonketotic acidosis . However, the paucity of reported deaths of patients with SCT in a natural disease setting suggests that many of these cases remain unrecognized.…”

Section: Discussionmentioning

confidence: 99%

Sickle Cell Trait as a Contributory Cause of Death in Natural Disease

Podduturi

Guileyardo

2015

Journal of Forensic Sciences

View full text Add to dashboard Cite

Sickle cell trait (SCT) affects 300 million people globally, and awareness is growing that SCT is not an entirely benign condition; however, most reported cases have been non-natural deaths. Autopsy records from the Baylor University Medical Center (BUMC) in Dallas, Texas, contained seven natural deaths from January 2007 to October 2013 in which micro-occlusive sickling was identified at autopsy and SCT confirmed by postmortem hemoglobin fractionation. Sickle crisis was never diagnosed clinically. These cases illustrate the importance of red cell morphology in autopsy material. When sickling is suspected, hemoglobin fractionation should be performed. If confirmed, SCT should be listed as an autopsy finding and the severity and distribution of sickling documented. Extensive micro-occlusive sickling should be considered contributory to death; however, its relative importance depends on all facts of the case. Accurate reporting should facilitate further research and the development of evidence-based preventative and supportive strategies for these patients.

show abstract

Sudden death in a patient newly diagnosed with diabetes having hyperosmolar non-ketotic acidosis with sickle cell trait

Cited by 10 publications

References 8 publications

Sickle cell trait and the potential risk of severe coronavirus disease 2019—A mini‐review

Sickle cell trait and the potential risk of severe coronavirus disease 2019—A mini‐review

Sudden Death During Prolonged Religious Fasting

Sickle Cell Trait as a Contributory Cause of Death in Natural Disease

Contact Info

Product

Resources

About