Challenges and Misconceptions in Sickle Cell Anemia

Sickle cell anemia is associated with a significant number of complications, including organ damage, pulmonary hypertension, and cervical vascular disease. One of the biggest misconceptions with sickle cell disease is a lack of appreciation for the intense pain experienced by patients, according to Thomas D. Coates, MD. There are generally no changes in heart rate, blood pressure, or blood count during episodes of pain, which tends to lead clinicians to underestimate the pain.

A related misconception with sickle cell anemia is the incidence of narcotic addiction. The relative incidence for true addiction is actually lower than most people believe, explains Coates, because patients with this disease have severe pain and have a legitimate need for narcotics.

A major challenge in the management of sickle cell anemia is that it is rare, and thus, most clinicians have little to no experience with the disease. While pediatric patients can often seek care in a sickle cell center, says Coates, adults have a greater difficulty accessing medical care for their disease. The majority of adults with sickle cell disease are treated in the emergency department, further complicating care transitions, adds Coates.