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Diverse manifestations of a sickle cell crisis
  1. Tumaj Hashemzehi1,
  2. Szabolcs Bertok2,
  3. Malwina Julia Figaszewska1 and
  4. Deepak Batura3
  1. 1 Medicine, London North West University Healthcare NHS Trust, Harrow, London, UK
  2. 2 Department of Medicine for Older People and Neuro-Rehabilitation Medicine, London North West University Healthcare NHS Trust, Harrow, London, UK
  3. 3 Urology, London North West University Healthcare NHS Trust, Harrow, London, UK
  1. Correspondence to Dr Deepak Batura; deepakbatura{at}


We describe the case of a 21-year-old man with a background of sickle cell disease (SCD) who was on acute presentation in a sickle cell crisis required immediate intensive care admission with red blood cell exchange and ventilatory support. He had right frontal lobe infarcts and extensive bilateral deep white matter lesions most likely secondary to fat embolism. Inpatient investigations demonstrated a patent foramen ovale, explaining the route of spread of the fat embolus. He then had a transcatheter closure of the atrial defect. The patient needed prolonged inpatient rehabilitation. He was discharged from hospital in a wheelchair secondary to severe lower limb neurology and bilateral knee heterotopic ossification. He lives with the possibility of early onset dementia and cognitive decline, requiring constant care. The case highlights the multiple manifestations of SCD and their diverse and debilitating consequences.

  • musculoskeletal and joint disorders
  • haematology (incl blood transfusion)
  • stroke
  • sickle cell disease
  • disability

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  • Contributors TH—data collection, initial draft. SB—data collection, revision of draft, images and bibliography. MJF—data collection, initial draft, revision of draft. DB—drafting, revision of draft, revision of bibliography, oversight.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.