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Sickle Cell Disease & Crisis

Also known as: sickle cell anaemia · vaso-occlusive crisis · SCD

An inherited haemoglobinopathy (HbS) causing chronic haemolytic anaemia and painful vaso-occlusive crises, with risks of infection, acute chest syndrome, stroke and cumulative organ damage.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Inherited (autosomal recessive); common in African and in some central-Indian/tribal populations; crises triggered by infection, dehydration, cold, hypoxia and stress.

Red flags — escalate / refer

Acute chest syndrome (chest pain, hypoxia, new infiltrate), stroke, splenic sequestration, aplastic crisis (parvovirus B19), priapism, or severe sepsis (functional asplenia) → emergency.

Work-up / diagnosis

1Confirm with haemoglobin electrophoresis/HPLC.
2In a crisis check FBC and reticulocytes, look for a trigger (infection, hypoxia), and assess for the specific complications above.

Management — overview

Crisis — prompt, adequate analgesia (often opioids), hydration, oxygen if hypoxic, warmth, and treat any infection.
Transfusion or exchange transfusion for severe complications (acute chest syndrome, stroke).
Prevention — penicillin prophylaxis and vaccination against encapsulated organisms, folic acid, and hydroxyurea to reduce crises; treat every fever promptly.

In-depthFull dosing & advanced protocol

Drug dosing

Analgesia (opioids in severe crisis) + IV fluids ± O₂

Vaso-occlusive crisis

Adult dose: Analgesia titrated to pain, per protocol
Route: IV / oral

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

Hydroxyurea + penicillin prophylaxis + folic acid

Crisis prevention and disease-modification

Adult dose: Per protocol
Route: Oral

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

Treat pain fast; watch acute chest syndrome

Give effective analgesia early — under-treated pain is a common failing.
Acute chest syndrome is a leading cause of death — low threshold to escalate and transfuse.
Functional asplenia makes any fever an emergency; hydroxyurea reduces crisis frequency.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

HypertensionPersistently raised arterial pressure (≥140/90 mmHg) — a leading, modifiable cause of stroke, heart attack, heart failure and kidney disease.DengueAn Aedes-borne viral febrile illness. Most cases self-limit, but plasma leakage can cause severe dengue — early recognition of warning signs and careful fluid therapy save lives.MalariaA mosquito-borne protozoal (Plasmodium) febrile illness. In India P. vivax and P. falciparum predominate; prompt diagnosis and species-specific treatment prevent severe disease.

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Analgesia (opioids in severe crisis) + IV fluids ± O₂

Hydroxyurea + penicillin prophylaxis + folic acid

📈 Treat pain fast; watch acute chest syndrome

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Analgesia (opioids in severe crisis) + IV fluids ± O₂

Hydroxyurea + penicillin prophylaxis + folic acid

📈 Treat pain fast; watch acute chest syndrome

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Treat pain fast; watch acute chest syndrome

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Treat pain fast; watch acute chest syndrome

References