TITLE:
From Lysis to Hemolysis
AUTHORS:
Mouhamed Dieng, Sokhna Aïssatou Touré, Mohamed Keïta, Boundia Djiba, Michel Assane Ndour, Demba Diedhiou, Moussa Seck, Sidy Mohamed Seck
KEYWORDS:
Sickle Cell Disease, Vitamin D, Osteomalacia
JOURNAL NAME:
Open Journal of Blood Diseases,
Vol.13 No.1,
February
15,
2023
ABSTRACT: Introduction: Sickle cell disease (SCD) is the most common genetic disease in the
world. Vitamin D deficiency has been described in several patients with this
disease. We
report the case of a patient in whom osteomalacia revealed the disease. Observation: The patient was 35 years old, not an alcoholic, not exposed to toxic
products, with a family history of sickle cell disease in her 4 brothers and
sisters. She reports the appearance of diffuse bone pain but which predominates
in the axial skeleton, the ribs and the rhizomelic zones having motivated
several hospitalizations. These pains are recurrent with new attacks on the
lumbar spine, and sacroiliac joints with intense pain. Paraclinical
examinations revealed: normal long bone radiographs without bone lysis, a CT
scan of the sacroiliac joints without any aspect of sacroiliitis, but revealing
multiple vertebral condensing bone lesions in streaks, diffuse at the level of
the iliac wings with osteolysis surrounded by non aggressive osteocondensation. Densitometry was normal, vitamin D
deficiency was noted at 29 ng/mL with elevated alkaline phosphatase, normal
concentrations of Calcemia and Phosphoremia respectively at 96 mg/L and 36 mg/L,
contrasting with hyperparathyroidism with a blood level of parathyroid hormone
elevated to twice the normal level at 104.4 pg/mL It should be noted that the patient
had received per os vitamin D supplementation before coming to us. The
diagnosis of osteomalacia secondary to vitamin D deficiency complicated by
secondary hyperparathyroidism was retained. Given the family history, we looked
for the existence of sickle cell disease which was finally confirmed on
hemoglobin electrophoresis with an AS profile. Conclusion: The
association between vitamin D deficiency and sickle cell disease is not
uncommon, and is explained by the ethnic origin, race, skin color, genetics and
physiological features of patients with this disease rather than the disease
itself.