Treatment For Sickle Cell Anemia

Question: What are the choices for treatment of sickle cell anemia? I don't have it but some different answers would be cool.

Answer: http://www.mayoclinic.com/health/sickle-cell-anemia/DS00324/DSECTION=treatments-and-drugs good website on this, do your research.

Question: How much do the treatment for Sickle Cell Anemia cost and what is the economic impact?

Answer: It depends on if you have insurance or not. If you have insurance pretty much everything is coverd. If not it can be very costly. Depending on the type you have and how severe your case is but there are many companys that help with illness like this. You have to see special doctors and have lots of test done.

Question: what is the most common treatment for sickle cell anemia? i need drugs for the treatment, not for the pain, just to treat it. i cant find anything. please help!!!!!

Answer: Sickle cell anemia is an autosomal recessive trait m it is resulted from a single glutamic acid to valine substitution at position 6 of the beta globin polypeptide chain. Since you did not ask about the jargons of the disease, I will just go straight into the management of it If you are diagnosed with sickle cell anemia, your doctor/specialist would give you PROPHYLAXIS with daily folic acid supplements and penicillin V ( to protect against pneumococcal infection ) You also should be vaccinated against pneumococcus and haemophilus influenza B and hepatitis B if possible. Having sickel cell disease , you are greatly prone to de-hydration, so when Vaso-occlusive pain arises (clogging of small vessels in the bone which produces great bone pain ) ,aggressive Re-Hydration is needed , also oxygen therapy , adequate analgesia ( a sedative to ease the pain), and antibiotics. Transfusion is also needed tp suppress HbS production and maintain its level below 30%. There is currently a new drug called Oral Cytotoxic agent Hydroxycarbamide which has been shown good clinical benefits with acceptable side effects. AS for complete cure of the disease , I am afraid there isnt any since it is a genetic disorder . However, the management therapies above can help greatly increase quality of life.

Question: availability of treatment for sickle cell anemia in developed and underdeveloped countries??? are there any differences in availibility of treatment for sickle cell anameia in developed and underdeveloped countries?? i would have thought that there would be because most treatment has been discovered and developed in more developed countries and because there richer countries have more money, they have greater access to the (limited) resources. and it may have something to do with creating a division between the rich and poor. but i can't find anything on the internet to give any more information.. can anyone perhaps direct me to suitable websites they can find ?? thanks

Answer: The quality of treatment would vary between developing and developed countries ... to put it simply a person in "sickle cell crisis" tends to be in immense pain and depending on how severe the crisis is they may need ICU treatment or at least hospitalisation...and there is a mayor difference between standards of care in developed countries compared to underdeveloped countries. I would even go so far as to say there is a diffence in care between a rural hospital and a metropolitin hospital...there is far more resources in large teaching hospital compared to the small country town clinic. You also have to keep in mind that only a small amount of the population has sickle cell anameia so a rural hospital is not likely to see anyone with that disease for years so when the unlucky person who has sickle cell anameia happens to walk into that emergency department in a sickle cell crisis the likelyhood of the staff knowing what to do is small. whereas large metropolitin hospitals would see at least a few sickle cell crisis a year so have more experience in the care of that person. Also developed countries have the resources to test babies at birth for sickle cell anameia and the sooner it is discovered the better the management and outcome is... In developed countries children with sickle cell anemia are seen on a regular basis in outpatient clinics attached to hospitals so that they are monitored and treated before they ended up in total crisis, you wouldn't get these clinics in developing countries, the money isn't there for them. In developing countries the discovery the child has sickle cell anemia would only occur once the child presented in a sickle cell crisis.

Question: what is the current treatment for sickle cell anemia acute chest syndrome? acute chest syndrome pain of SCA Crises

Answer: Patients with sickle cell disease need continous treatment, even when they are not having a painful crisis. Supplementation with folic acid, an essential element in producing cells, is required because of the rapid red blood cell turnover. The purpose of therapy is to manage and control symptoms and to try to limit the frequency of crises. During a sickle crisis, certain therapies may be necessary. Painful episodes are treated with analgesics and adequate liquid intake. Treatment of pain is critical. Non-narcotic medications may be effective, but some patients will require narcotics. Hydroxyurea (Hydrea) was found to help some patients by reducing the frequency of painful crises and episodes of acute chest syndrome and decreasing the need for blood transfusions. There has been some concern about the possibility of this drug causing leukemia, but as yet there are no definitive data that Hydrea causes leukemia in sickle cell patients. Newer drugs are being developed to manage sickle cell anemia. Some of these agents work by trying to induce the body to produce more fetal hemoglobin (therefore decreasing the amount of sickling) or by increasing the binding of oxygen to sickle cells. But as yet, there are no other widely used drugs that are available for treatment. Bone marrow transplants can be curative, this therapy is indicated in only a minority of patients, predominantly because of the high risk of the procedure (the drugs needed to make the transplant possible are highly toxic) and difficulty in finding suitable donors. Also, bone marrow transplants are much more expensive than other treatments. Antibiotics and vaccines are given to prevent bacteria infections, which are common in children with sickle cell disease. Additional treatments may include: partial exchange transfusion for acute chest syndrome transfusions or surgery for neurological events, such as strokes dialysis or kidney transplant for kidney disease irrigation or surgery for priapism surgery for eye problems hip replacement for avascular necrosis of the hip (death of the joint) gallbladder removal (if there is significant gallstone disease) wound care, zinc oxide, or surgery for leg ulcers drug rehabilitation and counseling for the psychosocial complications Hope That Helped!

Question: The decline in the occurrence of sickle cell anemia in the American population is most likely the result of? 1. the absence of mosquitoes. 2. the development of appropriate medical treatment for the sickle cell condition in the United States. 3. a lower mutation rate in the United States than in Africa. 4. a decline in the occurrence of malaria in the United States. 5. the advantage of both homozygous forms over the heterozygous form.

Answer: None of these. The decline has been because people who are heterozygous for the trait are more likely to marry normal people than another heterozygote than they have been historically. Hit your teacher with a clue bat. It's okay to marry someone who's not of your race.

Question: What kinds of treatments are there for sickle cell anemia? how do they work? what are their limitations? what kinds of treatments are there?

Answer: http://www.nlm.nih.gov/medlineplus/sicklecellanemia.html

Question: what kinds of treatments are there for sickle cell anemia? how do they work? what are their limitations? what kinds of treatments are there?

Answer: 1. One method for treating sickle cell anemia is to reduce the concentration of defective hemoglobin by stimulating the body to make other kinds of hemoglobin. Hydroxyurea Hydroxyurea (Droxia), a cancer medication, has been shown to reduce pain and complications in sickle cell anemia in adults. It is still being investigated for use in children, with special concern for how hydroxyurea may affect child growth and development. Butyrate, arginine Two other drugs being investigated to stimulate hemoglobin production are butyrate and arginine. Studies have shown both drugs not only increase healthy hemoglobin but reduce the symptoms of sickle cell anemia as well. 2. Since the pain of sickle cell anemia comes from blood vessels being blocked off, another method of treatment would be to get more oxygen to the painful areas. Poloxamer 188 Poloxamer 188 (Flocor), made by CytRx Corp., has been shown in studies to decrease the length of painful episodes in sickle cell anemia by improving blood flow in the tiny blood vessels around the painful area. In June 2001 the U.S. Food and Drug Administration (FDA) granted CytRx permission to put Flocor on the fast track for development, for treatment of acute chest syndrome. 3. Sickled red blood cells could also be made less "sticky" and thus less likely to block off blood vessels. Sulphasalazine A study published in 2001 showed that the drug sulphasalazine could reduce the number of "sticky" molecules on red blood cells in sickle cell anemia. 4. The gene that causes red blood cells to sickle was identified more than 40 years ago. Researchers are looking at two methods of using that knowledge for gene therapy: take out some of the person's cells, "fix" the defective gene, and put it back in the bone marrow so that only the correct version of the gene will be made figure out how to "turn off" the defective gene and "turn on" another gene that makes healthy hemoglobin. No doubt this and other research will reduce the pain and anemia of sickle cell disease, and perhaps even provide a cure.

Question: Sickle Cell Anemia Info? Can anyone give me some info on sickle cell anemia.the treatment && any other info... this is for a biology project on diseases..

Answer: Sickle cell anemia is a hereditary blood disease that occurs chiefly among blacks. It causes attacks that include severe pain, high fever and damage to body tissues. Sickle cell anemia may injure part of the body such as bones, central nervous system, liver, lungs and spleen. Some victims suffer blindness, convulsions, paralysis or loss of speech. Many die before reaching the age of 40. Sickle cell occurs if a person's red blood cells contain too many hemoglobin molecules that are abnormal. Hemoglobin gives the red blood cells their color. Too much of the abnormal hemoglobin causes the cells to change shape. When this occurs the amount of oxygen in the blood drops too low. The cells clog blood vessels and interfere with the flow of blood. This deprives the body tissue of oxygen and causes painful attacks. Treatment includes antibiotics, pain relieving medication, blood transfusions, bone marrow transplant and experimental treatment.

Question: What exactly is gene therapy when it comes to treating sickle cell anemia? Hey guys-just curious but what exactly is 'gene therapy'. I was reading an article about sickle cell anaemia and it said that one of the possible treatments could be 'gene therapy' can someone define this for me please? And what advantages and disadvantages does gene therapy have over the use of normal medication when it comes to treating sickle cell? Thanks everyone!

Answer: Gene therapy is inserting genes from other hosts to repair the dna

Question: Sickle Cell Anemia................? Does anybody have any information on sickle cell anemia like treatments, how it affects the person, support groups. Its for this big project im doin for biology worth about 50% of our term grade. Please help and also list resources.

Answer: Treatments and drugs Bone marrow transplant offers the only potential cure for sickle cell anemia. But very few people have a suitable donor for transplant. As a result, treatment for sickle cell anemia is usually aimed at avoiding crises, relieving symptoms and preventing complications. If you have sickle cell anemia, you'll need to make regular visits to your doctor to check your red blood cell count and monitor your health. You may also require treatment from specialists at a hospital or sickle cell anemia clinic. Treatments may include medications to reduce pain and prevent complications, blood transfusions and supplemental oxygen, as well as bone marrow transplant. Medications Medications used to treat sickle cell anemia include: Antibiotics. Children with sickle cell anemia usually begin taking the antibiotic penicillin when they're about 2 months of age and continue until they're 5 years old. Doing so helps prevent infections, such as pneumonia, which can be life-threatening to an infant or child with sickle cell anemia. Antibiotics may also help adults with sickle cell anemia fight certain infections. Pain-relieving medications. To relieve pain during a sickle crisis, your doctor may advise over-the-counter pain relievers and application of heat to the affected area. You may also need stronger prescription painkillers. Hydroxyurea (Droxia, Hydrea). This prescription drug, normally used to treat cancer, may be helpful for adults with severe disease. When taken daily, it reduces the frequency of painful crises and may reduce the need for blood transfusions. It seems to work by stimulating production of fetal hemoglobin — a type of hemoglobin found in newborns that helps prevent the formation of sickle cells. There is some concern about the possibility that long-term use of this drug may cause tumors or leukemia in certain people. Your doctor can help you determine if this drug may be beneficial for you. Blood transfusions In a red blood cell transfusion, red blood cells are removed from a supply of donated blood. These donated cells are then given intravenously to a person with sickle cell anemia. Blood transfusions increase the number of normal red blood cells in circulation, helping to relieve anemia. In children with sickle cell anemia at high risk of stroke, regular blood transfusions can decrease their risk of stroke. Blood transfusions carry some risk. Blood contains iron. Regular blood transfusions cause an excess amount of iron to build up in your body. Because excess iron can damage your heart, liver and other organs, people who undergo regular transfusions must often receive treatment to reduce iron levels. In 2005, the Food and Drug Administration approved deferasirox (Exjade), the first oral medication that can reduce excess iron levels, for use in people older than the age of 2. Supplemental oxygen Breathing supplemental oxygen through a breathing mask adds oxygen to your blood and helps you breathe easier. It may be helpful if you have acute chest syndrome or a sickle cell crisis. Bone marrow transplant This procedure allows people with sickle cell anemia to replace their bone marrow — and its sickle-shaped red blood cells — with healthy bone marrow from a donor who doesn't have the disease. It can be a cure, but the procedure is risky, and it's difficult to find suitable donors. Researchers are still studying bone marrow transplants for people with sickle cell anemia. Currently, the procedure is recommended only for people who have significant symptoms and problems from sickle cell anemia. In a bone marrow transplant, your bone marrow is first destroyed using chemotherapy or radiation. A matched donor's healthy bone marrow is removed using a minor surgical technique. You then receive a transfusion of that healthy marrow, and the healthy marrow may start producing normal blood cells. Sometimes, however, the transplant doesn't work or the recipient's body rejects the new marrow. The procedure requires a lengthy hospital stay. After the transplant, you'll need drugs to help prevent rejection of the donated marrow. Treating complications Doctors treat most complications of sickle cell anemia as they occur. Treatment may include antibiotics, blood transfusions, pain-relieving medicines, other medications and possibly surgery, such as to correct vision problems or to remove a damaged spleen. Experimental treatments Scientists continue to gain new insights into the symptoms and causes of sickle cell anemia. Some possible new treatments researchers are studying include: Gene therapy. Because sickle cell anemia is caused by a defective gene, researchers are exploring whether correcting this gene and inserting it into the bone marrow of people with sickle cell anemia will result in the production of normal hemoglobin. Scientists are also exploring the possibility of turning off the defective gene while reactivating another gene responsible for the

Question: What is the best treatment or medication for sickle cell diesease (sickle cell anaemia)? Please, save my son !

Answer: go here; http://www.doctoryourself.com/index.html

Question: what is the cause of sickle cell anemia? Why are the cell conditions different? What is the treatment for this?

Answer: Sickle cell anemia is an inherited blood disorder characterized primarily by chronic anemia and periodic episodes of pain. The underlying problem involves hemoglobin, a component of red blood cells. Hemoglobin molecules in each red blood cell carry oxygen from the lungs to body organs and tissues and bring carbon dioxide back to the lungs. In sickle cell anemia, the hemoglobin is defective. After hemoglobin molecules give up their oxygen, some may cluster together and form long, rod-like structures. These structures cause red blood cells to become stiff and assume a sickle shape. Unlike normal red cells, which are usually smooth and donut-shaped, sickled red cells cannot squeeze through small blood vessels. Instead, they stack up and cause blockages that deprive organs and tissues of oxygen-carrying blood. This process produces periodic episodes of pain and ultimately can damage tissues and vital organs and lead to other serious medical problems. Normal red blood cells live about 120 days in the bloodstream, but sickled red cells die after about 10 to 20 days. Because they cannot be replaced fast enough, the blood is chronically short of red blood cells, a condition called anemia.

Question: Alternative and Complimentry treatments for Sicke Cell Anemia? What do you guys personally think about alternative and complimentry treatments for Sickle Cell Anemia?

Answer: Promising therapies being investigated The following are some of the treatments for sickle cell anemia being investigated through research. 1. One method for treating sickle cell anemia is to reduce the concentration of defective hemoglobin by stimulating the body to make other kinds of hemoglobin. Hydroxyurea Hydroxyurea (Droxia), a cancer medication, has been shown to reduce pain and complications in sickle cell anemia in adults. It is still being investigated for use in children, with special concern for how hydroxyurea may affect child growth and development. [Wang, W. C., Helms, R. W., Lynn, H. S., et al. (2002) Effect of hydroxyurea on growth in children with sickle cell anemia: Results of the HUG-KIDS study. Journal of Pediatrics 140(2), pp 225-229] Butyrate, arginine Two other drugs being investigated to stimulate hemoglobin production are butyrate and arginine. Studies have shown both drugs not only increase healthy hemoglobin but reduce the symptoms of sickle cell anemia as well. [Armandola, E. A. (2002). Management of sickle cell anemia: New approaches. 7th Congress of the European Hematology Association.] 2. Since the pain of sickle cell anemia comes from blood vessels being blocked off, another method of treatment would be to get more oxygen to the painful areas. Poloxamer 188 Poloxamer 188 (Flocor), made by CytRx Corp., has been shown in studies to decrease the length of painful episodes in sickle cell anemia by improving blood flow in the tiny blood vessels around the painful area. In June 2001 the U.S. Food and Drug Administration (FDA) granted CytRx permission to put Flocor on the fast track for development, for treatment of acute chest syndrome. [Marlowe, K. F., & Chicella, M. F. (2002). Treatment of sickle cell pain. Pharmacotherapy 22(4), pp. 484-491.] 3. Sickled red blood cells could also be made less "sticky" and thus less likely to block off blood vessels. Sulphasalazine A study published in 2001 showed that the drug sulphasalazine could reduce the number of "sticky" molecules on red blood cells in sickle cell anemia. [Solovey, A. A., Solovey, A. N., Harkness, J., & Hebbel, R. P. (2001). Modulation of endothelial cell activation in sickle cell disease: A pilot study. Blood 97, pp. 1937-1941.] 4. The gene that causes red blood cells to sickle was identified more than 40 years ago. Researchers are looking at two methods of using that knowledge for gene therapy: take out some of the person's cells, "fix" the defective gene, and put it back in the bone marrow so that only the correct version of the gene will be made figure out how to "turn off" the defective gene and "turn on" another gene that makes healthy hemoglobin No doubt this and other research will reduce the pain and anemia of sickle cell disease, and perhaps even provide a cure.

Question: where do you think sickle cell anemia will be in 500 years? I mean where do you think the disease will be in terms of how many people have it and the treatment for it and stuff. I know this sounds like a homework question, and I can't really say this is just out of plain curiosity, but its a combo of both. I have to write a paper (im in 8th grade so this is my first scientific paper) on where I think SCA will be in 500 years and I already have a pretty good idea on what my thoughts are, but I wanted your guys's opinions.

Answer: within 20 years they will have a cure

Question: What is the connection between Hypoxia or sickle cell anemia and Pica for foam? I specifically need to know the expected behaviors of a person with this combined diagnosis and the most effective treatment of said

Answer: Sickle cell disease is an inherited disorder of the red blood cells characterized by abnormally shaped red cells. This abnormality can result in painful episodes, serious infections, chronic anemia, and damage to body organs. These effects can, however, vary from person to person depending on the type of sickle cell disease the person has. Some individuals are relatively healthy and others are hospitalized frequently. But thanks to advancements in early diagnosis and treatment, most children born with this disorder grow up to live relatively healthy and productive lives. A Closer Look at Sickle Cell Disease The different forms of sickle cell disease are determined by the genes that are inherited from the person's parents. An individual has the disease if he or she inherits a sickle cell gene from each parent (hemoglobin SS disease, also called sickle cell anemia). He or she can also inherit a sickle cell gene from one parent and a different kind of abnormal gene from the other and end up with a different form of sickle cell disease, such as hemoglobin SC disease and hemoglobin S-thalassemia. If an individual inherits only one sickle cell gene and a normal gene from the other parent, then he or she will have the sickle cell trait, but not the disease. A blood test can determine whether you have sickle cell disease or carry the sickle cell trait. People with sickle cell trait don't have sickle cell disease or exhibit any signs of the disorder, but they can pass the gene for the disease to their children. When both parents have the sickle cell trait, there's a 25% chance that a child will have sickle cell disease. But when one parent is carrying the trait and the other actually has the disease, the odds increase to 50% that they will pass the disorder on to their child. Who Does It Affect? In the United States, hemoglobin SS disease (sickle cell anemia) affects mostly African Americans and some Latino Americans. Some forms of sickle cell disease may occur, although less frequently, in people with different ethnic backgrounds such as those whose ancestors came from Mediterranean countries (including Turkey, Greece, and Italy) or East India. What Causes It? A child with sickle cell disease has inherited a defective hemoglobin gene. In a child with sickle cell disease, the hemoglobin can take on an abnormal shape, distorting the shape of the red blood cell. The cells change from a normal round, doughnut shape to the elongated shape of a sickle, or the shape of a "C." Unlike normal red blood cells, which move easily through small blood vessels, sickle cells are hard and pointed. The sickle shape means that they have a tendency to get stuck in narrow blood vessels and block the flow of blood. This can cause episodes of pain and can also lead to damage of the body organs because they aren't getting enough oxygen. Sickle cells have a shorter-than-normal life span, which leads to anemia (low red blood cell count). A normal red blood cell lives for about 120 days, whereas a sickle cell lives for only 10 to 20 days. How Is It Diagnosed? Usually, sickle cell disease is diagnosed at birth with a blood test. This can be done in conjunction with other routine newborn screening tests. If your child tests positive on the screening test, a second blood test is usually performed to confirm the diagnosis. Because children with sickle cell disease are at an increased risk of infection and other health complications, early diagnosis and treatment is important. Currently, more than 40 states have newborn screening programs for sickle cell disease. What Are the Signs and Symptoms? Symptoms of sickle cell disease vary and range from mild to severe, and symptoms may be less severe or different in children who have inherited a sickle cell gene from one parent and a different abnormal hemoglobin gene from the other. Most children with sickle cell disease have some degree of anemia, and they may develop one or more of the following conditions and symptoms as part of the disorder: Acute chest syndrome: Infection or trapped red blood cells in the lungs cause this syndrome. Signs include chest pain, coughing, difficulty breathing, and fever. Aplastic crisis: This is when the bone marrow temporarily slows its production of red blood cells due to infection or another cause. Signs include paleness and fatigue. Hand-foot syndrome (also called dactylitis): This may be the first sign of sickle cell anemia in some infants. Signs include painful swelling of the hands and feet and fever. Infection: Children with sickle cell disease are at increased risk for certain bacterial infections. It's important to watch for fevers of 101 degrees Fahrenheit (38 degrees Celsius) or higher, which could signal an infection. Children with sickle cell disease and fever should be seen by a doctor immediately. Painful crises: These may occur in any part of a child's body. They may be brought on by cold or dehydration. The pain may last a few hours or up to 2 weeks or even longer. Splenic sequestration crises: The spleen becomes enlarged by trapping (or sequestering) the abnormal red blood cells. This leads to fewer cells in the general circulation. Early signs include paleness, weakness, an enlarged spleen, and pain in the abdomen. Stroke: Poor blood flow in the brain can occur from the sickle-shaped cells blocking small blood vessels. This may lead to a stroke. Signs may include headache, seizures, weakness of the arms and legs, speech problems, a facial droop, and loss of consciousness. Other possible complications include leg ulcers, bone or joint damage, gallstones, kidney damage, painful prolonged erections in males (called priapism), eye damage, and delayed growth. How Is It Treated? Aside from a bone marrow transplant, there's no known cure for sickle cell disease. Transplants are complicated procedures and aren't an option for everyone. To qualify, a child would need a bone marrow donor providing a match with a low risk of being rejected. Even then, there are significant risks to the procedure, and there's always the chance of rejection of the transplanted marrow. But even without a cure, children with sickle cell disease can lead relatively normal lives. Medicines are available to help manage the pain, whereas immunizations and daily doses of penicillin (an antibiotic) can help prevent infection. Infection used to cause many deaths in infants with sickle cell disease, but thanks to penicillin and appropriate immunizations, children with sickle cell disease are much more likely to live longer, healthier lives. Although penicillin isn't a cure, it can help prevent life-threatening infections due to bacteria that cause serious infections such as sepsis (a severe infection of the blood), meningitis, and pneumonia in children with sickle cell disease. Infants and kids with sickle cell disease usually require two daily doses of penicillin, as prescribed by their doctors, until they're at least 5 years old. In addition, they should be fully immunized with the regular childhood vaccinations as well as influenza and meningococcal vaccines. Most doctors also prescribe daily vitamin supplements for children with sickle cell disease. Folic acid, in particular, can help a child with the disorder produce new red blood cells. In addition, children with sickle cell disease who develop serious complications (such as acute chest syndrome, severe anemia, or stroke) may receive regular transfusions of red blood cells to prevent or treat these complications. Hydroxyurea is a drug that has been used for over a decade in adults with sickle cell disease. In 1998, the U.S. Food and Drug Administration (FDA) approved the use of hydroxyurea in patients over 18 years old, however, it has still not been approved for use in children. Hydroxyurea increases the amount of fetal hemoglobin in the person's blood cells, which interferes with the sickling process and makes red blood cells less sticky. This helps decrease the number and intensity of painful episodes and other complications. The drug has been proven to decrease pain and other complications in children as well as adults. Research is continuing to determine the drug's long-term effects and safety. When Should I Call My Child's Doctor? Seek emergency medical attention and call your child's hematologist immediately if your child with sickle cell disease develops any of the following: fever of 101 degrees Fahrenheit (38 degrees Celsius) or higher pain that isn't relieved by medication chest pain shortness of breath or trouble breathing severe headaches or dizziness severe stomach pain or swelling jaundice or extreme paleness painful erection in males sudden change in vision seizures weakness or inability to move any part of the body loss of consciousness Caring for Your Child In addition to your child's primary care doctor, your child should receive regular care from a hematologist (a blood specialist) or a sickle cell clinic. It's important to share your concerns and to discuss any new symptoms or complications with your child's doctor or nurse. Your child should also be given plenty of fluids, get plenty of rest, and avoid extreme temperatures. Most people with sickle cell disease now live into their mid-40s and beyond. The most critical time is the first few years of life, which is why early diagnosis and treatment are so important Pica for Foam Rubber in Patients With Sickle Cell Disease from Southern Medical Journal Discussion Pica cases are often interesting, and the cases presented here certainly raise several questions. Perhaps the best way to conceptualize these cases is from a biopsychosocial perspective. From a biologic standpoint, we know of no clear etiology or any other medical factors related to repeated and long-term ingestion of this specific material. The question certainly arises, though, of whether this meets some biochemical need not previously characterized. Other anemic states, including iron deficiency and lead poisoning, have been associated with pica, although not for foam rubber.[8, 9] We speculate with regard to the roles of the smell of the substance (which is often distinctive), the stimulation of the chewing process, and whether patients truly believe on some level that foam rubber has nutritional value. What we do know, of course, is that there are potential hazards to ingesting foam rubber.[7, 10] The unknown hazards could be more concerning. From a psychologic standpoint, we currently know little about this specific type of pica. Others have discussed pica within the context of obsessive-compulsive disorders in general.[5, 11] In addition, we can speculate that anxiety, boredom, and poor environmental stimulation could be salient factors. Yet, none of these three cases presented with symptoms or histories requisite to highlight any of those areas or to make any psychologic diagnoses other than pica (except as noted in Patient 3). Full psychologic evaluations would be necessary to further explore this area in these patients, but the costs could be prohibitive and would probably need to be completed within a funded research project. As for psychologic treatment, there is some evidence for the effectiveness of behavioral strategies;[12, 13] others have reported the use of pharmacologic agents.[5, 11] From a social standpoint, two issues readily come to mind. First, we wonder what impact familial ingestion of other nonfood items has on a patient's pica for other items, including foam rubber. In Patient 1, the patient's grandmother was reported to have a lengthy history of eating clay dirt as well as baking soda, and this was accepted within the family. We have also met other teenage patients with pica (not for foam rubber) with family members who routinely ingested a different set of substances; in each case, the family was still clearly disturbed by the patient's pica. Still, at what point does modeling for any pica simply beget a different pica? Second, we wonder whether patients with pica have a history of having little available food in the household, thus prompting them to ingest nonfood items. As far as we can determine, however, this was not the case for the three patients presented here. Were it not that other clinicians have reported similar cases,[3, 4] these might be less intriguing; however, the impression gained is that pica for foam rubber may not be that unusual in patients with sickle cell disease. Indeed, others have noted that foam rubber appears to be an item of choice for sickle cell disease patients with pica.[14] We hope that this report spurs further clinical and research interest in the area, specifically regarding prevalence/incidence, etiology, potential hazards of ingestion, and effective interventions. Reviewed by: Steven Dowshen, MD, and Barbara P. Homeier, MD Date reviewed: April 2005