LDH, SGOT, direct and indirect bilirubin, alkaline phosphatase are markedly increased. BUN, Cr, and CPK may also be elevated. LUQ pain, early satiety, nausea, vomiting, dizziness, orthostatic hypotension may be present. In children, listlessness, increased pallor, and increasing spleen size may be the only findings. Seen in children with Hb SS, SC, or SThal and adults with Hb SC or SThal.
Exam reveals increased jaundice and splenomegaly.
Lab findings are often the same as with hepatic sequestration, however, increasing anemia with a high reticulocyte count may be the only findings. Presents with abdominal pain and often a history of dysuria, frequency, fever, chills, suprapubic or back pain. Exam shows fever, CVA and suprapubic tenderness. Lab reveals leukocytosis with left shift on CBC and WBCs, casts, bacteria on urinalysis in classic presentations. Hemoglobinopathy patients may have increased incidence of kidney stones from increased excretion of uric acid.