Bone marrow necrosis and fat embolism: an autopsy report of a severe complication of hemoglobin SC disease

  • Fernando Peixoto Ferraz de Campos Department of Internal Medicine – Hospital Universitário – Universidade de São Paulo, São Paulo/SP
  • Cristiane Rúbia Ferreira Anatomic Pathology Service – Hospital Universitário – Universidade de São Paulo, São Paulo/SP
  • Aloisio Felipe-Silva Anatomic Pathology Service – Hospital Universitário – Universidade de São Paulo, São Paulo/SP
Keywords: Anemia, Sickle Cell, Hemoglobin SC Disease, Embolism, Fat, Multiple Organ Failure, Acute Chest Syndrome

Abstract

Sickle Cell Disease encompasses a group of disorders related with the hemoglobin S and other hemoglobin genotypes. The clinical manifestation and the severity of symptoms are dependent on the specific genotype. In this setting, homozygous genotype (HbSS) presents an early onset of symptoms and a low expectancy of lifetime. However, the SC genotype (HbSC), which apparently shows a less severe clinical course, may exhibit the same complications of HbSS. These complications are usually manifested late in the course of life, when compared with the HbSS patients. It is noteworthy that HbSC may present a normal hematocrit, and therefore stays unknown until the first complication, that may be disastrous. The authors report a case of an African-Descendant woman, aging 65 years, with no previous diagnosis of anemia who sought medical attention because of a thoracic back pain followed by fever and altered mental status. The clinical picture deteriorated very fast with multiple organ failure and death. The autopsy findings concluded by generalized vaso-occlusive crisis, bone marrow necrosis and bone marrow and fat embolism, mainly to the lungs and kidney. The authors call attention for the knowledge of this severe life threatening complication, mainly in a country with a high Afro-Descendant population.

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Published
2014-06-26
How to Cite
Campos, F., Ferreira, C., & Felipe-Silva, A. (2014). Bone marrow necrosis and fat embolism: an autopsy report of a severe complication of hemoglobin SC disease. Autopsy and Case Reports, 4(2), 9-20. https://doi.org/10.4322/acr.%y.82530
Section
Article / Autopsy Case Report