Value of complete blood count in sickle cell vaso-occlusive crisis

Presented is an evaluation of the value of complete blood count (CBC) in the management and disposition of children with sickle cell disease (SCD) presented with vaso-occlusive crisis (VOC). A retrospective record review (between January 1 and July 31, 1999) of children below 18 years with SCD are presented with VOC. A complete blood count and differential was performed on each patient. Demographic, clinical and other laboratory data was obtained on every child. All patients were followed up for two weeks after their emergency room (ER) visit. Sixty-eight patients (42 males, 26 females) were studied. Mean values (SD) for duration of pain prior to presentation was 31.4 hours (37.6), for hemoglobin (Hb) concentration 9.32 g/dL (1.44mmol/L) (1.38), white blood count (WBC) 12.9 × 1,000 cells/mm³ (7.54). Seven patients had a rectal temperature above 38°C. Eight patients were hospitalized and, except for a higher WBC, all other studies were not different than in those who were discharged home. No patient required blood transfusion. In the absence of toxicity, risk factors or focus of infection, a routine CBC is not recommended for children with SCD who present with VOC.