REVERSAL OF MULTIORGAN SYSTEM DYSFUNCTION IN SICKLE-CELL DISEASE WITHPLASMA-EXCHANGE

A 23-year-old man with sickle cell anemia and multiorgan system dysfun ction was treated with plasma exchange during a sickle cell crisis. Th e patient failed to respond to conventional treatment including hydrat ion, blood transfusions, broad spectrum antibiotics, supplemental oxyg en, and analgesics. The clinical picture resembled thrombotic thromboc ytopenic purpura (TTP), and the patient responded dramatically to plas ma exchange with reversal of a rapidly deteriorating clinical state. T his case illustrates possible similarities in the pathophysiology of T TP and sickle cell crisis, and the value of plasma exchange in related critical disease states. (C) Acta Anaesthesiologica Scandinavica 41 ( 1997).