背景:镰状细胞病是一种常见的遗传性血红蛋白病,与高发病率和高死亡率相关。血管闭塞危象通常发生在患有SCD的个体中,其由于末端器官缺血和梗塞而导致高发病率。这些包括脾梗死,肺部受累,急性胸部综合征,和眼眶压迫综合征.SCD的眼部表现包括眼前段缺血,继发性青光眼,角状条纹,视网膜病变,和视网膜动脉阻塞.通常报道的镰状细胞病发病率的原因是极端温度,风速,和降雨。这项研究对暴露于高海拔地区的镰状细胞患者的复发性眶骨骨膜下血肿进行了调查。
方法:一名患有SCD的12岁男孩在访问高海拔地区时反复出现突发性眶周疼痛和肿胀。该家庭先前报告了两次类似的袭击。患者完全康复,及时开始保守治疗。该案例研究是关于纯合子SCD,先前有类似的疼痛性眶周肿胀发作史,经保守治疗后解决。这种情况与眼球突出有关,复视,和限制眼球运动。眼眶磁共振成像显示右眶顶邻近眶壁的骨膜下肿块,被鉴定为骨膜下血肿,诱导突起。随访7天后患者出院。
结论:在SCD的血管闭塞危象期间,眶骨梗死表现为急速进行性的眶周疼痛性肿胀。血肿经常使病情复杂化,以及可能导致眼眶压迫综合征的炎性肿胀。这种情况威胁视力,需要及时诊断并进行适当的管理。这种情况要求立即开始保守治疗并密切监测视神经功能,以防止年轻患者的永久性视力丧失。
BACKGROUND: Sickle cell disease is a common inherited hemoglobinopathy and is associated with high morbidity and mortality. Vaso-occlusive crises commonly occur in individuals with
SCD that results in high morbidity due to end-organ ischemia and infarction. These include splenic infarction, pulmonary involvement, acute chest syndrome, and orbital compression syndrome. Ocular manifestations of
SCD include anterior segment ischemia, secondary glaucoma, angoid streaks, retinopathy, and retinal artery occlusion. Commonly reported causes for the incidence of sickle cell disease are extreme temperatures, wind speed, and rainfall. This study has conducted an investigation of recurrent orbital bone sub-periosteal hematoma in a sickle cell patient that was exposed to high altitude areas.
METHODS: A 12-year-old boy with
SCD developed a recurrent sudden periorbital pain and swelling during a visit to high altitude area. The family reported two similar attacks previously. The patient recovered completely with timely initiated conservative treatment. The
case study is about homozygous
SCD with previous history of similar attack of painful periorbital swelling that resolved after conservative management. This condition was associated with proptosis, diplopia, and restriction of eye movement. Magnetic resonance imaging of the orbits showed right orbital roof subperiosteal mass adjacent to the orbital wall, which was identified as a subperiosteal haematoma, inducing proptosis. The patient was discharged after 7 days with follow up.
CONCLUSIONS: Infarction of orbital bones during vaso-occlusive crises in
SCD presented acutely with a rapidly progressive painful periorbital swelling. Hematomas frequently complicate the condition, along with the inflammatory swelling that may lead to the orbital compression syndrome. The condition is sight-threatening and necessitates prompt diagnosis along with appropriate management. This condition mandates prompt initiation of conservative treatment and close monitoring of the optic nerve functions to prevent permanent visual loss in young patients.