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Case Reports in Transplantation
Volume 2015, Article ID 761740, 3 pages
http://dx.doi.org/10.1155/2015/761740
Case Report

Acute Sickle Hepatic Crisis after Liver Transplantation in a Patient with Hb SC Disease

1Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, TN 38104, USA
2Department of Surgery, The University of Tennessee Health Science Center, Memphis, TN 38104, USA
3Methodist University Hospital Transplant Institute, Memphis, TN 38104, USA

Received 7 November 2014; Revised 7 February 2015; Accepted 7 February 2015

Academic Editor: Giuseppe Orlando

Copyright © 2015 J. H. Gillis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute sickle hepatic crisis (ASHC) has been observed in approximately 10% of patients with sickle cell disease. It occurs predominantly in patients with homozygous (Hb SS) sickle cell anemia and to a lesser degree in patients with Hb SC disease, sickle cell trait, and Hb S beta thalassemia. Patients commonly present with jaundice, right upper quadrant pain, nausea, low-grade fever, tender hepatomegaly, and mild to moderate elevations in serum AST, ALT, and bilirubin. We describe the case of a patient with a history of hemoglobin SC disease and cirrhosis caused by hepatitis C presenting approximately 1 year after liver transplantation with an ASHC. The diagnosis was confirmed by liver biopsy. Our patient was treated with RBC exchange transfusions, IV hydration, and analgesia and made a complete recovery. Only a limited number of patients with sickle cell disease have received liver transplants, and, to our knowledge, this is the first case of ASHC after transplantation in a patient with Hb SC disease.