Clinical report addresses management of sickle cell disease in children, teens

Management of children and adolescents with sickle cell disease (SCD) requires comprehensive care from a pediatric primary care provider and a multidisciplinary team, according to a clinical report published online July 22 in Pediatrics.

Amber M. Yates, M.D., from the Baylor College of Medicine and Texas Children's Hospital in Houston, and colleagues present an overview focusing on the practical management of children and adolescents with SCD.

The authors note that SCD is a complex disorder with multisystem manifestations requiring comprehensive care from a pediatric primary care provider and a multidisciplinary SCD team. All aspects of general pediatric care should be managed by the pediatric primary care provider, and they should co-manage SCD-specific manifestations with the SCD team. The patient and family should be involved in all decisions. At least annual consultation with a multidisciplinary SCD team is strongly advised, although the extent to which the comprehensive care is delivered by a pediatric primary care provider versus the multidisciplinary specialist team will vary by community as well as family preference and the frequency and severity of SCD manifestations. Age-specific screening for disease complications is important at all SCD comprehensive visits. Education about and planning for urgent medical evaluation should be developed early and reviewed at each visit. The patient and family should be made aware that SCD is treatable but requires attention and active management to achieve optimum life outcomes.

"Improvements in care have resulted in almost all children with SCD surviving into adulthood and transitioning into adult care, which has allowed shifting the goal of care to improved quality of life," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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