Aspectos clínicos-epidemiológicos e percepção de dor na anemia falsiforme.

Abstract

Sickle Cell Disease (SCD) is one of the main and most frequent genetic illnesses that attack human beings. It is characterized by the predominance of S hemoglobin (HbS) with clear clinical manifestations: sickle cell anemia (HbSS) and associations with other variants of hemoglobin: HbC, HbD and thalassemias (a and b). It is predominant among black and dark-skinned people. There is an estimate of more than 7,200,000 people with the sickle cell trait in Brazil, and 3,500 children are born yearly with SCD. Erythrocytes with S hemoglobin, under conditions of hypoxia, take on the shape of a sickle, with the possibility of leading to a total occlusion of the capillaries, causing acute tissue lesions, with pain crisis and chronic lesion of organs. Illnesses, exposure to cold and stress are factors that can trigger the crisis. Pain due to the crisis of vein-occlusion is the major cause of hospitalization and is associated to early death. By means of home visits, interviews were carried out with SCD, collecting clinical-epidemiologic and pain data. The patients lived in Uberaba, and were 18 or more years old. Among the 47 sample patients there were: 78% black; 17% dark-skinned; 4.3% white; 59.6% females. Type of hemoglobinopathy: 63.8% SS; 17% SC; 10.6% Sb thalassemias; 78.7% have already had blood transfusions. Pain crisis: frequent crisis in 85.1%, with an average of 7.02 crisis per year. Measurement of pain: END average 5.5 (moderate pain); MPQ 35.9. Most frequent places: lower limbs 74.5%, shoulders and upper limbs 57.4%, lumbar and sacral spine, coccyx 53.2%. Predominant season: winter (68.1%). Feelings in relation to the illness: acceptance 38.3%, revolt 21.3%, sadness 17%. Changes after diagnosis: 46.8% get worse in relation to work, 31.9% in relation to leisure. It is possible to conclude that the illness affects the person at all levels and the pain can be totally incapacitating for many of the patients with SCD.