How I treat acute and persistent sickle cell pain
Main Article Content
Keywords
Sickle cell disease, Sickle cell anemia, Pain, Vaso-occlusive crisis
Abstract
Sickle pain is the hallmark of sickle cell disease (SCD). It could be acute, persistent/relapsing, chronic or neuropathic. Although there is a general consensus that pain is a major manifestation of SCD there is a controversy as to the types of pain and their interrelationship between acute, chronic, relapsing, persistent, etc. This report first reviews the general approach to the management of acute vaso-occlusive crisis (VOC) pain including education, counseling, pharmacotherapy, non-pharmacotherapy, and fluid therapy. This is followed by the presentation of five patients that represent typical issues that are commonly encountered in the management of patients with SCD. These issues are: individualized treatment of pain, bilaterality of pain, use of illicit drugs, tolerance to opioids, opioid induced hyperalgesia and withdrawal syndrome. The clinical aspects and management of each of these issues are described. Moreover, such complications as tolerance and withdrawal may persist after discharge and may be mistaken as chronic pain rather than resolving, persistent or relapsing pain.
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References
References:
1. Smith WR, Penberthy LT, Bovbjerg VE, McClish DK, Roberts JD, Dahman B, et al. Daily assessment of pain in adults with sickle cell disease. Ann Intern Med. 2008;148(2):94–101.
2. Dampier C, Ely B, Brodecki D, O'Neal P. Characteristics of pain managed at home in children and adolescents with sickle cell disease by using diary self-reports. J Pain. 2002;3(6):461–70.
3. Ballas SK, Bauserman RL, McCarthy WF, Castro OL, Smith WR, Waclawiw MA. Hydroxyurea and acute painful crises in sickle cell anemia: effects on hospital length of stay and opioid utilization during hospitalization, outpatient acute care contacts, and at home. J Pain Symptom Manage. 2010;40(6):870-82.
4. Ballas SK. Sickle Cell Pain, 2nd Edition. Washington DC: International Association for the Study of Pain; 2014.
5. Ballas SK, Gupta K, Adams-Graves P. Sickle cell pain: a critical reappraisal. Blood. 2012;120(18):3647-56.
6. Yawn BP, Buchanan GR, Afenyi-Annan AN, Ballas SK, Hassell KL, James AH, et al. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members. JAMA. 2014;312(10):1033-48.
7. Ballas SK, Smith ED. Red blood cell changes during the evolution of the sickle cell painful crisis. Blood. 1992;79(8):2154-63.
8. Pentin PL. Drug seeking or pain crisis? Responsible prescribing of opioids in the emergency department. Virtual Mentor. 2013;15(5):410-5.
9. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016. MMWR Recomm Rep. 2016;65(1):1-49.
10. Ballas SK. Pathophysiology and principles of management of the many faces of the acute vaso-occlusive crisis in patients with sickle cell disease. Eur J Haematol. 2015;95(2):113-23.
11. Ballas SK. More definitions in sickle cell disease: steady state v base line data. Am J Hematol. 2012;87(3):338.
12. Expert Panel Report. Evidence-Based Management of Sickle Cell Disease Bethesda MD: National Heart, Lung, and Blood Institute; 2014 [Available from: http://www.nhlbi.nih.gov/health-pro/guidelines/sickle-cell-disease-guidelines/].
13. Ballas SK. Pain management of sickle cell disease. Hematol Oncol Clin North Am. 2005;19(5):785-802.
14. Ballas SK. Update on pain management in sickle cell disease. Hemoglobin. 2011;35(5):520-9.
15. Ruta NS, Ballas SK. The Opioid Drug Epidemic and Sickle Cell Disease: Guilt by Association. Pain Med. 2016;17(10):1793-8.
16. Carden MA, Fay M, Sakurai Y, McFarland B, Blanche S, DiPrete C, et al. Normal saline is associated with increased sickle red cell stiffness and prolonged transit times in a microfluidic model of the capillary system. Microcirculation. 2017;24(5).
17. Carden MA, Fay ME, Lu X, Mannino RG, Sakurai Y, Ciciliano JC, et al. Extracellular fluid tonicity impacts sickle red blood cell deformability and adhesion. Blood. 2017;130(24):2654-63.
18. Ballas SK. Of pools, oceans, and the Dead Sea. Blood. 2017;130(24):2578-9.
19. Gardner JW. Death by water intoxication. Mil Med. 2002;167(5):432-4.
20. Gutmann FD, Gardner JW. Fatal water intoxication of an Army trainee during urine drug testing. Mil Med. 2002;167(5):435-7.
21. Serjeant G. Blood transfusion in sickle cell disease: a cautionary tale. Lancet. 2003;361(9369):1659-60.
22. Ballas SK. Self-management of sickle cell disease: a new frontier. J Natl Med Assoc. 2010;102(11):1042-3.
23. Tanabe P, Porter J, Creary M, Kirkwood E, Miller S, Ahmed-Williams E, et al. A qualitative analysis of best self-management practices: sickle cell disease. J Natl Med Assoc. 2010;102(11):1033-41.
24. Ballas SK. Sickle cell disease: current clinical management. Semin Hematol. 2001;38(4):307-14.
25. Waldhoer M, Bartlett SE, Whistler JL. Opioid receptors. Annu Rev Biochem. 2004;73:953-90.
26. Manglik A, Kruse AC, Kobilka TS, Thian FS, Mathiesen JM, Sunahara RK, et al. Crystal structure of the micro-opioid receptor bound to a morphinan antagonist. Nature. 2012;485(7398):321–6.
27. Cox BM. Recent developments in the study of opioid receptors. Mol Pharmacol. 2013;83:723–8.
28. Koppert W, Schmelz M. The impact of opioid-induced hyperalgesia for postoperative pain. Best Pract Res Clin Anaesthesiol. 2007;21(1):65-83.
29. Martyn JAJ, Mao J, Bittner EA. Opioid Tolerance in Critical Illness. N Engl J Med. 2019;380(4):365-78.
30. Kang M, Mischel RA, Bhave S, Komla E, Cho A, Huang C, et al. The effect of gut microbiome on tolerance to morphine mediated antinociception in mice. Sci Rep. 2017;7:42658.
31. Akbarali HI, Dewey WL. The gut-brain interaction in opioid tolerance. Curr Opin Pharmacol. 2017;37:126-30.
32. Mischel RA, Dewey WL, Akbarali HI. Tolerance to Morphine-Induced Inhibition of TTX-R Sodium Channels in Dorsal Root Ganglia Neurons Is Modulated by Gut-Derived Mediators. iScience. 2018;2:193-209.
33. Breedlove S.M., Watson N.V. Behavioral Neuroscience, Eighth Edition. Oxford University Press New York, NY; 2018.
34. CNS Forum. NMDA Receptor. CNS Forum2002.
35. de Vos JW, Ufkes JG, Kaplan CD, Tursch M, Krause JK, van Wilgenburg H, et al. L-Methadone and D,L-methadone in methadone maintenance treatment: a comparison of therapeutic effectiveness and plasma concentrations. Eur Addict Res. 1998;4(3):134-41.
36. Wedekind D, Jacobs S, Karg I, Luedecke C, Schneider U, Cimander K, et al. Psychiatric comorbidity and additional abuse of drugs in maintenance treatment with L- and D,L-methadone. World J Biol Psychiatry. 2010;11(2 Pt 2):390-9.
37. Zhang Y, Tao GJ, Hu L, Qu J, Han Y, Zhang G, et al. Lidocaine alleviates morphine tolerance via AMPK-SOCS3-dependent neuroinflammation suppression in the spinal cord. J Neuroinflammation. 2017;14(1):211.
38. Swe KM, Abas AB, Bhardwaj A, Barua A, Nair NS. Zinc supplements for treating thalassaemia and sickle cell disease. Cochrane Database Syst Rev. 2013;6:CD009415.
39. Li Y, Shu Y, Ji Q, Liu J, He X, Li W. Attenuation of morphine analgesic tolerance by rosuvastatin in naive and morphine tolerance rats. Inflammation. 2015;38(1):134-41.
40. Deng XT, Han Y, Liu WT, Song XJ. B Vitamins Potentiate Acute Morphine Antinociception and Attenuate the Development of Tolerance to Chronic Morphine in Mice. Pain Med. 2017;18(10):1961-74.
41. Wang Y, Barker K, Shi S, Diaz M, Mo B, Gutstein HB. Blockade of PDGFR-beta activation eliminates morphine analgesic tolerance. Nat Med. 2012;18(3):385–7.
42. Donica CL, Cui Y, Shi S, Gutstein HB. Platelet-derived growth factor receptor-beta antagonism restores morphine analgesic potency against neuropathic pain. PLoS One. 2014;9(5):e97105.
43. Stankovic Stojanovic K, Thioliere B, Garandeau E, Lecomte I, Bachmeyer C, Lionnet F. Chronic myeloid leukaemia and sickle cell disease: could imatinib prevent vaso-occlusive crisis? Br J Haematol. 2011;155(2):271-2.
44. Murphy M, Close J, Lottenberg R, Rajasekhar A. Effectiveness of imatinib therapy for sickle cell anemia and chronic myeloid leukemia. Am J Med Sci. 2014;347(3):254-5.
45. Koren G, Cairns J, Chitayat D, Gaedigk A, Leeder SJ. Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother. Lancet. 2006;368(9536):704.
46. Sajantila A. Editors' pick: codeine toxicity prediction in young infants - genotype the mothers. Investig Genet. 2012;3(1):24.
47. McClish DK, Smith WR, Dahman BA, Levenson JL, Roberts JD, Penberthy LT, et al. Pain site frequency and location in sickle cell disease: the PiSCES project. Pain. 2009;145(1-2):246-51.
48. Serjeant GR, Chalmers RM. Current concerns in haematology. 1. Is the painful crisis of sickle cell disease a "steal" syndrome? J Clin Pathol. 1990;43(10):789–91.
49. Rathmell J.P., Fields HL. Pain: pathophysiology and management. In: Longo DL, Fauci AS, Kasey S, Hauser R, Jameson LS, Loscaizo JL, editors. Harrison's Principles of Internal Medicine. New York, NY: McGraw Hill; 2012. p. 93-101.
50. Woolf CJ. Evidence for a central component of post-injury pain hypersensitivity. Nature. 1983;306(5944):686-8.
51. Cervero F, Laird JM. Visceral pain. Lancet. 1999;353(9170):2145-8.
52. Busse SM, McMillen PT, Levin M. Cross-limb communication during Xenopus hindlimb regenerative response: non-local bioelectric injury signals. Development. 2018;145(19).
53. Youssef F, Pater A, Shehata M. Opioid-induced Hyperalgesia. J Pain Relief. 2015;4:183-5.
54. Benjamin LJ, Payne R. Pain in sickle cell disease: a multidimensional construct. In: Pace B, editor. Renaissance of Sickle Cell Disease Research in the Genomic Era. London: Imperial College Press; 2007. p. 99-118.
55. de Montalembert M, Ferster A, Colombatti R, Rees DC, Gulbis B. ENERCA clinical recommendations for disease management and prevention of complications of sickle cell disease in children. Am J Hematol. 2011;86(1):72–5.
56. Ferrini F, Trang T, Mattioli TA, Laffray S, Del'guidice T, Lorenzo LE, et al. Morphine hyperalgesia gated through microglia-mediated disruption of neuronal Cl(-) homeostasis. Nat Neurosci. 2013;16:183–92.
57. Allen NJ, Barres BA. Neuroscience: Glia - more than just brain glue. Nature. 2009;457(7230):675-7.
58. Ballas SK, Lusardi M. Hospital readmission for adult acute sickle cell painful episodes: frequency, etiology, and prognostic significance. Am J Hematol. 2005;79(1):17-25.
59. Burma NE, Kwok CH, Trang T. Therapies and mechanisms of opioid withdrawal. Pain Manag. 2017;7(6):455-9.
60. Kenna GA, Nielsen DM, Mello P, Schiesl A, Swift RM. Pharmacotherapy of dual substance abuse and dependence. CNS Drugs. 2007;21(3):213-37.
61. NIDA. FDA approves first medication to reduce opioid withdrawal symptoms National Institute on Drug Abuse website2018 [Available from: https://www.drugabuse.gov/news-events/news-releases/2018/05/fda-approves-first-medication-to-reduce-opioid-withdrawal-symptoms].
62. Gish EC, Miller JL, Honey BL, Johnson PN. Lofexidine, an {alpha}2-receptor agonist for opioid detoxification. Ann Pharmacother. 2010;44(2):343-51.
63. Gorodetzky CW, Walsh SL, Martin PR, Saxon AJ, Gullo KL, Biswas K. A phase III, randomized, multi-center, double blind, placebo controlled study of safety and efficacy of lofexidine for relief of symptoms in individuals undergoing inpatient opioid withdrawal. Drug Alcohol Depend. 2017;176:79-88.
64. Law FD, Diaper AM, Melichar JK, Coulton S, Nutt DJ, Myles JS. Buprenorphine/naloxone versus methadone and lofexidine in community stabilisation and detoxification: A randomised controlled trial of low dose short-term opiate-dependent individuals. J Psychopharmacol. 2017;31(8):1046-55.
65. Ballas SK, Talacki CA, Rao VM, Steiner RM. The prevalence of avascular necrosis in sickle cell anemia: correlation with alpha-thalassemia. Hemoglobin. 1989;13(7-8):649-55.
66. Milner PF, Kraus AP, Sebes JI, Sleeper LA, Dukes KA, Embury SH, et al. Sickle cell disease as a cause of osteonecrosis of the femoral head. N Engl J Med. 1991;325(21):1476-81.
67. Minniti CP, Eckman J, Sebastiani P, Steinberg MH, Ballas SK. Leg ulcers in sickle cell disease. Am J Hematol. 2010;85(10):831-3.
68. Dampier C, Palermo TM, Darbari DS, Hassell K, Smith W, Zempsky W. AAPT Diagnostic Criteria for Chronic Sickle Cell Disease Pain. J Pain. 2017;18(5):490-8.
69. Chapman CR, Vierck CJ. The Transition of Acute Postoperative Pain to Chronic Pain: An Integrative Overview of Research on Mechanisms. J Pain. 2017;18(4):359.e1-.e38.
70. Kent ML, Tighe PJ, Belfer I, Brennan TJ, Bruehl S, Brummett CM, et al. The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions. J Pain. 2017;18(5):479-89.
71. Osunkwo I, Veeramreddy P, Arnall J, Crawford R, Symanowski JT, Olaosebikan R, et al. Use of Buprenorphine/Naloxone in Ameliorating Acute Care Utilization and Chronic Opioid Use in Adults with Sickle Cell Disease. Blood. 2019;134 (Suppl 1):790.
1. Smith WR, Penberthy LT, Bovbjerg VE, McClish DK, Roberts JD, Dahman B, et al. Daily assessment of pain in adults with sickle cell disease. Ann Intern Med. 2008;148(2):94–101.
2. Dampier C, Ely B, Brodecki D, O'Neal P. Characteristics of pain managed at home in children and adolescents with sickle cell disease by using diary self-reports. J Pain. 2002;3(6):461–70.
3. Ballas SK, Bauserman RL, McCarthy WF, Castro OL, Smith WR, Waclawiw MA. Hydroxyurea and acute painful crises in sickle cell anemia: effects on hospital length of stay and opioid utilization during hospitalization, outpatient acute care contacts, and at home. J Pain Symptom Manage. 2010;40(6):870-82.
4. Ballas SK. Sickle Cell Pain, 2nd Edition. Washington DC: International Association for the Study of Pain; 2014.
5. Ballas SK, Gupta K, Adams-Graves P. Sickle cell pain: a critical reappraisal. Blood. 2012;120(18):3647-56.
6. Yawn BP, Buchanan GR, Afenyi-Annan AN, Ballas SK, Hassell KL, James AH, et al. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members. JAMA. 2014;312(10):1033-48.
7. Ballas SK, Smith ED. Red blood cell changes during the evolution of the sickle cell painful crisis. Blood. 1992;79(8):2154-63.
8. Pentin PL. Drug seeking or pain crisis? Responsible prescribing of opioids in the emergency department. Virtual Mentor. 2013;15(5):410-5.
9. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016. MMWR Recomm Rep. 2016;65(1):1-49.
10. Ballas SK. Pathophysiology and principles of management of the many faces of the acute vaso-occlusive crisis in patients with sickle cell disease. Eur J Haematol. 2015;95(2):113-23.
11. Ballas SK. More definitions in sickle cell disease: steady state v base line data. Am J Hematol. 2012;87(3):338.
12. Expert Panel Report. Evidence-Based Management of Sickle Cell Disease Bethesda MD: National Heart, Lung, and Blood Institute; 2014 [Available from: http://www.nhlbi.nih.gov/health-pro/guidelines/sickle-cell-disease-guidelines/].
13. Ballas SK. Pain management of sickle cell disease. Hematol Oncol Clin North Am. 2005;19(5):785-802.
14. Ballas SK. Update on pain management in sickle cell disease. Hemoglobin. 2011;35(5):520-9.
15. Ruta NS, Ballas SK. The Opioid Drug Epidemic and Sickle Cell Disease: Guilt by Association. Pain Med. 2016;17(10):1793-8.
16. Carden MA, Fay M, Sakurai Y, McFarland B, Blanche S, DiPrete C, et al. Normal saline is associated with increased sickle red cell stiffness and prolonged transit times in a microfluidic model of the capillary system. Microcirculation. 2017;24(5).
17. Carden MA, Fay ME, Lu X, Mannino RG, Sakurai Y, Ciciliano JC, et al. Extracellular fluid tonicity impacts sickle red blood cell deformability and adhesion. Blood. 2017;130(24):2654-63.
18. Ballas SK. Of pools, oceans, and the Dead Sea. Blood. 2017;130(24):2578-9.
19. Gardner JW. Death by water intoxication. Mil Med. 2002;167(5):432-4.
20. Gutmann FD, Gardner JW. Fatal water intoxication of an Army trainee during urine drug testing. Mil Med. 2002;167(5):435-7.
21. Serjeant G. Blood transfusion in sickle cell disease: a cautionary tale. Lancet. 2003;361(9369):1659-60.
22. Ballas SK. Self-management of sickle cell disease: a new frontier. J Natl Med Assoc. 2010;102(11):1042-3.
23. Tanabe P, Porter J, Creary M, Kirkwood E, Miller S, Ahmed-Williams E, et al. A qualitative analysis of best self-management practices: sickle cell disease. J Natl Med Assoc. 2010;102(11):1033-41.
24. Ballas SK. Sickle cell disease: current clinical management. Semin Hematol. 2001;38(4):307-14.
25. Waldhoer M, Bartlett SE, Whistler JL. Opioid receptors. Annu Rev Biochem. 2004;73:953-90.
26. Manglik A, Kruse AC, Kobilka TS, Thian FS, Mathiesen JM, Sunahara RK, et al. Crystal structure of the micro-opioid receptor bound to a morphinan antagonist. Nature. 2012;485(7398):321–6.
27. Cox BM. Recent developments in the study of opioid receptors. Mol Pharmacol. 2013;83:723–8.
28. Koppert W, Schmelz M. The impact of opioid-induced hyperalgesia for postoperative pain. Best Pract Res Clin Anaesthesiol. 2007;21(1):65-83.
29. Martyn JAJ, Mao J, Bittner EA. Opioid Tolerance in Critical Illness. N Engl J Med. 2019;380(4):365-78.
30. Kang M, Mischel RA, Bhave S, Komla E, Cho A, Huang C, et al. The effect of gut microbiome on tolerance to morphine mediated antinociception in mice. Sci Rep. 2017;7:42658.
31. Akbarali HI, Dewey WL. The gut-brain interaction in opioid tolerance. Curr Opin Pharmacol. 2017;37:126-30.
32. Mischel RA, Dewey WL, Akbarali HI. Tolerance to Morphine-Induced Inhibition of TTX-R Sodium Channels in Dorsal Root Ganglia Neurons Is Modulated by Gut-Derived Mediators. iScience. 2018;2:193-209.
33. Breedlove S.M., Watson N.V. Behavioral Neuroscience, Eighth Edition. Oxford University Press New York, NY; 2018.
34. CNS Forum. NMDA Receptor. CNS Forum2002.
35. de Vos JW, Ufkes JG, Kaplan CD, Tursch M, Krause JK, van Wilgenburg H, et al. L-Methadone and D,L-methadone in methadone maintenance treatment: a comparison of therapeutic effectiveness and plasma concentrations. Eur Addict Res. 1998;4(3):134-41.
36. Wedekind D, Jacobs S, Karg I, Luedecke C, Schneider U, Cimander K, et al. Psychiatric comorbidity and additional abuse of drugs in maintenance treatment with L- and D,L-methadone. World J Biol Psychiatry. 2010;11(2 Pt 2):390-9.
37. Zhang Y, Tao GJ, Hu L, Qu J, Han Y, Zhang G, et al. Lidocaine alleviates morphine tolerance via AMPK-SOCS3-dependent neuroinflammation suppression in the spinal cord. J Neuroinflammation. 2017;14(1):211.
38. Swe KM, Abas AB, Bhardwaj A, Barua A, Nair NS. Zinc supplements for treating thalassaemia and sickle cell disease. Cochrane Database Syst Rev. 2013;6:CD009415.
39. Li Y, Shu Y, Ji Q, Liu J, He X, Li W. Attenuation of morphine analgesic tolerance by rosuvastatin in naive and morphine tolerance rats. Inflammation. 2015;38(1):134-41.
40. Deng XT, Han Y, Liu WT, Song XJ. B Vitamins Potentiate Acute Morphine Antinociception and Attenuate the Development of Tolerance to Chronic Morphine in Mice. Pain Med. 2017;18(10):1961-74.
41. Wang Y, Barker K, Shi S, Diaz M, Mo B, Gutstein HB. Blockade of PDGFR-beta activation eliminates morphine analgesic tolerance. Nat Med. 2012;18(3):385–7.
42. Donica CL, Cui Y, Shi S, Gutstein HB. Platelet-derived growth factor receptor-beta antagonism restores morphine analgesic potency against neuropathic pain. PLoS One. 2014;9(5):e97105.
43. Stankovic Stojanovic K, Thioliere B, Garandeau E, Lecomte I, Bachmeyer C, Lionnet F. Chronic myeloid leukaemia and sickle cell disease: could imatinib prevent vaso-occlusive crisis? Br J Haematol. 2011;155(2):271-2.
44. Murphy M, Close J, Lottenberg R, Rajasekhar A. Effectiveness of imatinib therapy for sickle cell anemia and chronic myeloid leukemia. Am J Med Sci. 2014;347(3):254-5.
45. Koren G, Cairns J, Chitayat D, Gaedigk A, Leeder SJ. Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother. Lancet. 2006;368(9536):704.
46. Sajantila A. Editors' pick: codeine toxicity prediction in young infants - genotype the mothers. Investig Genet. 2012;3(1):24.
47. McClish DK, Smith WR, Dahman BA, Levenson JL, Roberts JD, Penberthy LT, et al. Pain site frequency and location in sickle cell disease: the PiSCES project. Pain. 2009;145(1-2):246-51.
48. Serjeant GR, Chalmers RM. Current concerns in haematology. 1. Is the painful crisis of sickle cell disease a "steal" syndrome? J Clin Pathol. 1990;43(10):789–91.
49. Rathmell J.P., Fields HL. Pain: pathophysiology and management. In: Longo DL, Fauci AS, Kasey S, Hauser R, Jameson LS, Loscaizo JL, editors. Harrison's Principles of Internal Medicine. New York, NY: McGraw Hill; 2012. p. 93-101.
50. Woolf CJ. Evidence for a central component of post-injury pain hypersensitivity. Nature. 1983;306(5944):686-8.
51. Cervero F, Laird JM. Visceral pain. Lancet. 1999;353(9170):2145-8.
52. Busse SM, McMillen PT, Levin M. Cross-limb communication during Xenopus hindlimb regenerative response: non-local bioelectric injury signals. Development. 2018;145(19).
53. Youssef F, Pater A, Shehata M. Opioid-induced Hyperalgesia. J Pain Relief. 2015;4:183-5.
54. Benjamin LJ, Payne R. Pain in sickle cell disease: a multidimensional construct. In: Pace B, editor. Renaissance of Sickle Cell Disease Research in the Genomic Era. London: Imperial College Press; 2007. p. 99-118.
55. de Montalembert M, Ferster A, Colombatti R, Rees DC, Gulbis B. ENERCA clinical recommendations for disease management and prevention of complications of sickle cell disease in children. Am J Hematol. 2011;86(1):72–5.
56. Ferrini F, Trang T, Mattioli TA, Laffray S, Del'guidice T, Lorenzo LE, et al. Morphine hyperalgesia gated through microglia-mediated disruption of neuronal Cl(-) homeostasis. Nat Neurosci. 2013;16:183–92.
57. Allen NJ, Barres BA. Neuroscience: Glia - more than just brain glue. Nature. 2009;457(7230):675-7.
58. Ballas SK, Lusardi M. Hospital readmission for adult acute sickle cell painful episodes: frequency, etiology, and prognostic significance. Am J Hematol. 2005;79(1):17-25.
59. Burma NE, Kwok CH, Trang T. Therapies and mechanisms of opioid withdrawal. Pain Manag. 2017;7(6):455-9.
60. Kenna GA, Nielsen DM, Mello P, Schiesl A, Swift RM. Pharmacotherapy of dual substance abuse and dependence. CNS Drugs. 2007;21(3):213-37.
61. NIDA. FDA approves first medication to reduce opioid withdrawal symptoms National Institute on Drug Abuse website2018 [Available from: https://www.drugabuse.gov/news-events/news-releases/2018/05/fda-approves-first-medication-to-reduce-opioid-withdrawal-symptoms].
62. Gish EC, Miller JL, Honey BL, Johnson PN. Lofexidine, an {alpha}2-receptor agonist for opioid detoxification. Ann Pharmacother. 2010;44(2):343-51.
63. Gorodetzky CW, Walsh SL, Martin PR, Saxon AJ, Gullo KL, Biswas K. A phase III, randomized, multi-center, double blind, placebo controlled study of safety and efficacy of lofexidine for relief of symptoms in individuals undergoing inpatient opioid withdrawal. Drug Alcohol Depend. 2017;176:79-88.
64. Law FD, Diaper AM, Melichar JK, Coulton S, Nutt DJ, Myles JS. Buprenorphine/naloxone versus methadone and lofexidine in community stabilisation and detoxification: A randomised controlled trial of low dose short-term opiate-dependent individuals. J Psychopharmacol. 2017;31(8):1046-55.
65. Ballas SK, Talacki CA, Rao VM, Steiner RM. The prevalence of avascular necrosis in sickle cell anemia: correlation with alpha-thalassemia. Hemoglobin. 1989;13(7-8):649-55.
66. Milner PF, Kraus AP, Sebes JI, Sleeper LA, Dukes KA, Embury SH, et al. Sickle cell disease as a cause of osteonecrosis of the femoral head. N Engl J Med. 1991;325(21):1476-81.
67. Minniti CP, Eckman J, Sebastiani P, Steinberg MH, Ballas SK. Leg ulcers in sickle cell disease. Am J Hematol. 2010;85(10):831-3.
68. Dampier C, Palermo TM, Darbari DS, Hassell K, Smith W, Zempsky W. AAPT Diagnostic Criteria for Chronic Sickle Cell Disease Pain. J Pain. 2017;18(5):490-8.
69. Chapman CR, Vierck CJ. The Transition of Acute Postoperative Pain to Chronic Pain: An Integrative Overview of Research on Mechanisms. J Pain. 2017;18(4):359.e1-.e38.
70. Kent ML, Tighe PJ, Belfer I, Brennan TJ, Bruehl S, Brummett CM, et al. The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions. J Pain. 2017;18(5):479-89.
71. Osunkwo I, Veeramreddy P, Arnall J, Crawford R, Symanowski JT, Olaosebikan R, et al. Use of Buprenorphine/Naloxone in Ameliorating Acute Care Utilization and Chronic Opioid Use in Adults with Sickle Cell Disease. Blood. 2019;134 (Suppl 1):790.
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Sep 8, 2020
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Ballas, S. (2020) “How I treat acute and persistent sickle cell pain ”, Mediterranean Journal of Hematology and Infectious Diseases, 12(1), p. e2020064. doi: 10.4084/mjhid.2020.064.
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