Aplastic crisis in sickle cell disease

It is often triggered by a viral infection and requires prompt medical assessment. Because red blood cells already have a shorter lifespan in sickle cell disease, even a temporary production pause can make the haemoglobin level fall quickly. Treatment depends on symptoms and blood results and may include close observation, supportive care, or a blood transfusion.

The bone marrow temporarily makes far fewer new red blood cells. A blood count may show worsening anaemia, while a reticulocyte count shows that few young red blood cells are entering circulation. This pattern helps distinguish an aplastic crisis from problems in which red blood cells are being destroyed rapidly. Fatigue, pallor, breathlessness, dizziness, a fast heartbeat, or reduced activity can accompany the anaemia.

Contact the person's sickle cell team or seek same-day medical assessment if an aplastic crisis is suspected. Clinicians usually check a full blood count and reticulocyte count, review recent fever or viral symptoms, and compare the findings with the person's usual haemoglobin. Until assessed, encourage rest and fluids if the person can drink, continue prescribed medicines unless instructed otherwise, and avoid strenuous activity.

Go to emergency care for difficulty breathing, chest pain, fainting, confusion, extreme drowsiness, severe weakness, a very fast heartbeat, or rapidly increasing paleness. Fever in someone with sickle cell disease also needs urgent clinical advice because infection can become serious. Do not wait for a routine appointment when these signs are present.

Ask how the current haemoglobin and reticulocyte count compare with the usual values, whether hospital monitoring or transfusion is needed, and what symptoms should prompt an immediate return. Families can also ask how to reduce infection spread at home and when normal school, work, exercise, or travel can resume.