This complication is usually, but not invariably, associated with pain crisis. History may be signs or symptoms of precipitating infection, nausea and vomiting. Physical exam shows rapidly enlarging tender liver with increasing jaundice. Patient may be hypotensive. Bowel sounds are often present.
Lab shows a rapid decrease in hemoglobin level over baseline.
WBC, platelets and reticulocyte count are high. 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.