The Coincidence of Sickle Cell Anemia with Systemic Lupus Erythematosus: A Case Report

Abstract

In Saudi Arabia, Sickle Cell Disease (SCD) is one of the most frequent hematological illnesses. This case report is about an eleven-year-old Saudi girl diagnosed with SCD and subsequently developed SLE. She was diagnosed with SCD at the age of nine and began on hydroxyurea; since then, she has regulated her discomfort and maintained frequent follow-ups. Then a high liver enzyme appeared, which was first assumed to be connected to hydroxyurea, and the central team decided to hold it until the liver enzyme returned to normal. She was eventually diagnosed with SLE and autoimmune hepatitis. Furthermore, the patient was identified with autoimmune hepatitis and a high liver enzyme, making it difficult to either keep hydroxyurea or continue despite this. Laboratory testing discovered low hemoglobin (10 mg/dl) and excessive LDH (228). Following that, the patient was diagnosed with hemolytic anemia and hemoglobin electrophoresis. Following hemoglobinopathy, the patient was admitted to the hospital as a case of newly identified sickle cell illness, and hydroxyurea urea, folic acid, and Transcranial Doppler Us were prescribed. The patient claims that after starting hydroxyurea, her bone pain has greatly reduced, and her ER visits have decreased. Furthermore, the patient was only brought to the general ward once the hydroxyurea was stopped as a case of Vaso-occlusive. The patient returned to the hematology OPD for follow-up after the procedure. Because the patient's liver enzymes remained elevated, he was diagnosed with immunologic autoimmune hepatitis. As a result, the patient was diagnosed with an autoimmune illness (early phase). The patient was also referred to Riyadh for rheumatology evaluation to rule out autoimmune illnesses. The patient had further tested in Riyadh as part of the rheumatology service. Anti-SLE medicine was prescribed for the patient. This patient was hospitalized many times, primarily for sickle cell illness and a vaso-occlusive crisis. Blood cultures were then found to be positive for salmonella and staphylococcus aureus, which were treated empirically with antibiotics.