Therapeutic apheresis : official journal of the International Society for Apheresis and the Japanese Society for Apheresis · 2000
Do automated red cell exchanges relieve priapism in patients with sickle cell anemia?
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McCarthy L J, Vattuone J, Weidner J, Skipworth E, Fernandez C, Jackson L, Rothenberger S, Waxman D, Miraglia C, Porcu P, Danielson C F
Аннотация
Priapism is a dramatic, painful complication for some men afflicted by sickle cell anemia. Although the natural history remains unclear, many believe replacing the patient's abnormal red blood cells (RBCs) with normal RBCs by apheresis is effective. However, no controlled trials have demonstrated its effectiveness. We exchanged 7 men after medical management failed. All procedures reduced sickle hemoglobin levels to < 30%. Two patients underwent emergency automated red cell exchanges without any detumescence or reduction of pain. The remaining 5 patients were exchanged non-emergently; 4 experienced no detumescence or relief of pain. One adult experienced resolution 8 h postexchange. However, he had a history of "stuttering" priapism. All required decompression procedures. Automated RBC exchanges were not effective in achieving detumescence or reducing pain.