Sickle cell disease(SCD)is strongly associated with severe preeclampsia and has also been linked to poor pregnancy-related outcomes.Moreover,sickle cell nephropathy(SCN)is a common complication of SCD and results in c...Sickle cell disease(SCD)is strongly associated with severe preeclampsia and has also been linked to poor pregnancy-related outcomes.Moreover,sickle cell nephropathy(SCN)is a common complication of SCD and results in chronic proteinuria.Pregnant patients with SCD who present to the emergency department(ED)with pulmonary edema,hypertension,and proteinuria may suffer from a hypertensive emergency with or without preeclampsia.Without prior lab work to determine whether a patient’s proteinuria or kidney dysfunction is new or at baseline,it may be impossible for the emergency physician to determine which diagnosis is more likely.Thus,amultidisciplinary approach which involves cardiology,nephrology,medicine and obstetrics consultations should be utilized to help direct treatment.We present the case of a 39-yearold patient with SCD,who was also 26 weeks pregnant,and presented to the ED with markedly elevated blood pressure and dyspnea.Although she was initially admitted to the obstetrics ward for blood pressure management given concern for preeclampsia,she was ultimately diagnosed with hypertensive emergency and sickle cell nephropathy.展开更多
文摘Sickle cell disease(SCD)is strongly associated with severe preeclampsia and has also been linked to poor pregnancy-related outcomes.Moreover,sickle cell nephropathy(SCN)is a common complication of SCD and results in chronic proteinuria.Pregnant patients with SCD who present to the emergency department(ED)with pulmonary edema,hypertension,and proteinuria may suffer from a hypertensive emergency with or without preeclampsia.Without prior lab work to determine whether a patient’s proteinuria or kidney dysfunction is new or at baseline,it may be impossible for the emergency physician to determine which diagnosis is more likely.Thus,amultidisciplinary approach which involves cardiology,nephrology,medicine and obstetrics consultations should be utilized to help direct treatment.We present the case of a 39-yearold patient with SCD,who was also 26 weeks pregnant,and presented to the ED with markedly elevated blood pressure and dyspnea.Although she was initially admitted to the obstetrics ward for blood pressure management given concern for preeclampsia,she was ultimately diagnosed with hypertensive emergency and sickle cell nephropathy.
