HISTORY AND CLINICAL FINDINGS: A 43-year-old @entity1 of Ghanaian origin presented with severe upper @entity490 starting on a long distance flight. Physical examination revealed @entity925 in the left upper abdomen and flank. There was no report of pre-existing conditions or permanent medication in the medical history. INVESTIGATIONS AND DIAGNOSIS: Laboratory tests showed signs of @entity5714 and elevated inflammatory parameters. The "thick blood smear" was normal. Ultrasonography revealed an enlarged spleen (14 5   cm) with inhomogeneous parenchyma and vast, diffusely spread @entity75 in perihilar location, interpreted as extended @entity1188 . Symptom onset on a long distance flight, @entity5714 and extended @entity1188 led to the assumption of a vasoocclusive crisis with haemolysis. Moleculargenetic tests proved the presence of @entity3458 and heterozygous @entity7723 . TREATMENT AND COURSE: After infusion of crystalloid solution the @entity1 was asymptomatic further on. Due to @entity1188 she received prophylactic treatment with Cefuroxim. A vaccination against pneumococci, meningococci and Haemophilus influenza B was recommended. CONCLUSIONS: Mild @entity519 and @entity2700 on a long distance flight can trigger a sickle cell crisis and may contribute to late clinical manifestation and diagnosis of @entity3458 in some cases. @entity1 suffering from @entity3458 are at risk for the same life-threatening complications as @entity1 with HbSS- @entity3458 . @entity3458 should not be considered as a mild form of HbSS- @entity3458 but as a separate disease with specific clinical manifestations. In contrast-enhanced ultrasonography, @entity1188 due to sickle cell crisis may markedly differ from "typical" arterial @entity1188 .

[Severe upper XXXX during a long distance flight].

@entity1 :: ('9606', 'Species') :: ['Patients', 'woman', 'patients', 'patient'] @entity7723 :: ('MESH:D017085', 'Disease') :: ['alpha-thalassemia'] @entity2700 :: ('MESH:D003681', 'Disease') :: ['dehydration'] @entity75 :: ('MESH:D001927', 'Disease') :: ['hypoechoic lesions'] @entity3458 :: ('MESH:D000755', 'Disease') :: ['HbSC-sickle cell disease', 'sickle cell disease'] @entity519 :: ('MESH:D000860', 'Disease') :: ['hypoxia'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['thromboembolic infarction', 'splenic infarction'] @entity5714 :: ('MESH:D000743', 'Disease') :: ['haemolytic anemia'] @entity490 :: ('MESH:D015746', 'Disease') :: ['abdominal pain'] @entity925 :: ('MESH:D063806', 'Disease') :: ['tenderness on palpation']
@entity490 :: (MESH:D015746,Disease) :: ['abdominal pain']
