SHM Converge Scientific Abstract ePoster Gallery-Splenic Infarct While Skiing: Rare Presentation of Sickle Cell Trait

Pdf Summary

This case report describes a rare complication of sickle cell trait (SCT): splenic infarction triggered by high-altitude exposure. SCT is usually considered benign, but hypoxic stress can precipitate infarction, most often reported in African-American males. Here, a previously healthy 28-year-old Caucasian man developed four days of left upper quadrant pain after skiing at 11,000 feet (3,300 m).<br /><br />Initial evaluation showed mild normocytic anemia, elevated D-dimer, and later evidence of hemolysis including elevated LDH, very low haptoglobin, and increased reticulocyte index. CT imaging of the chest, abdomen, and pelvis revealed multiple wedge-shaped splenic infarcts, splenomegaly, and patent splenic vessels. A broad hypercoagulable workup was negative, including tests for antiphospholipid syndrome, Factor V Leiden, JAK2 mutation, and PNH.<br /><br />Because of the association between SCT and high-altitude splenic infarction, hemoglobin electrophoresis was performed and confirmed SCT with HbS 39.5%. The patient was admitted for pain control and treated with anticoagulation due to symptomatic clot burden; anticoagulation was stopped after three months.<br /><br />The report emphasizes that splenic infarction should be considered in patients with abdominal pain after high-altitude exposure, even in White individuals, and that SCT may be underrecognized in this population. Management is usually supportive, with anticoagulation reserved for selected cases. Patients with SCT should be counseled to avoid or minimize known triggers such as hypoxia, dehydration, and strenuous exertion at altitude.

Asset Subtitle

Amanda S. Fryd

Meta Tag

Author List Amanda S. Fryd, Amna Rana, Harrison Winters, Paul Sackstein, Pedro Alcedo, Sarah Thornton

Category Clinical Vignettes

Concept Splenic Infarction

Concept Sickle Cell Trait

Concept Hemoglobin Electrophoresis

Concept Hypoxia

Concept High Altitude

Distinguished Non-Finalist

Presenter Organization MedStar Georgetown University Hospital

Presenting Author Amanda S. Fryd

Track Adult

Keywords

sickle cell trait

splenic infarction

high-altitude exposure

hypoxia

left upper quadrant pain

hemolysis

hemoglobin electrophoresis

splenomegaly

anticoagulation

abdominal pain

Splenic Infarction

Sickle Cell Trait

Hemoglobin Electrophoresis

Hypoxia

High Altitude