SHM Converge Scientific Abstract ePoster Gallery-What Goes Up Must Come Back Down: Recurrent Priapism Due to Sickle Cell Trait

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This case report describes a 51-year-old African American man with recurrent, painful stuttering priapism ultimately found to have sickle cell trait (SCT), an uncommon cause of vaso-occlusive symptoms. Over three months, he experienced five episodes of priapism, each lasting one to four days and requiring repeated corporal aspirations and intracavernous epinephrine injections with only temporary relief. He denied phosphodiesterase inhibitor use, and urine toxicology was negative, though he had a history of methamphetamine use disorder and hypertension.<br /><br />On admission, he had a two-week persistent priapism, mild anemia, and a positive sickle cell screen. Peripheral smear did not show sickled cells, but hemoglobin electrophoresis later demonstrated hemoglobin S of 37%, confirming SCT. Beta globin sequencing showed no additional deletions or duplications, and he had no known family history of sickle cell disease or trait.<br /><br />During hospitalization, he underwent a Winter shunt and then an Al Ghorab shunt with bilateral corporal dilation. Although detumescence was initially achieved, the priapism recurred due to shunt failure. He ultimately required takedown of the priapism and insertion of a semi-rigid penile prosthesis, which resolved the condition. Red blood cell exchange transfusion was considered but not performed because confirmatory testing returned after procedures were completed. He was discharged with hematology follow-up.<br /><br />The report emphasizes that while vaso-occlusive complications are common in sickle cell disease, they are unusual in SCT. However, priapism can still occur as a rare manifestation of SCT, sometimes triggered by factors such as trauma, drug use, or sexual activity. Clinicians should consider SCT in the differential diagnosis of recurrent priapism to ensure appropriate screening and timely management.

Asset Subtitle

Madison A. Chakoumakos

Meta Tag

Author List Jeremy Chang, Madison A. Chakoumakos, Nicholas Wu, Sherry Zhang

Category Clinical Vignettes

Concept Priapism

Concept Sickle Cell Trait

Concept Sickle Cell Disease

Concept Hemoglobin Electrophoresis

Concept Vaso-occlusive complication

Distinguished Non-Finalist

Presenter Organization University of California, San Diego School of Medicine

Presenting Author Madison A. Chakoumakos

Track Adult

Keywords

stuttering priapism

sickle cell trait

vaso-occlusive symptoms

hemoglobin S

corporal aspiration

intracavernous epinephrine

Winter shunt

Al Ghorab shunt

penile prosthesis

recurrent priapism

Priapism

Sickle Cell Trait

Sickle Cell Disease

Hemoglobin Electrophoresis

Vaso-occlusive complication