Diagnosis and family screening
Diagnosis uses haemoglobin electrophoresis or HPLC, supported by a blood count and blood film. Solubility testing is not sufficient on its own. Newborn or early childhood diagnosis allows preventive care to start early.
Sickle cell trait is different from sickle cell disease. Genetic counselling and partner or family screening are important for family planning.
Related: Haematology → · Dr. Sachita Baniya profile → · All conditions →
Complications to watch for
Vaso-occlusive pain crises are the most common complication. Acute chest syndrome, stroke, splenic sequestration, priapism, severe anaemia and infection are emergencies that need urgent hospital care.
Chronic problems include avascular necrosis, kidney disease, retinopathy, leg ulcers and pulmonary hypertension. Regular review looks for these before they become advanced.
- Fever in a child or adult with sickle cell disease
- Chest pain, breathlessness or low oxygen
- Sudden weakness, speech change or severe headache
- Priapism lasting more than two hours
Long-term treatment
Care includes hydration, pain management, penicillin prophylaxis and vaccination in children, folic acid where indicated, hydroxyurea for selected patients, and transfusion for specific complications. Newer disease-modifying therapies are considered in specialist centres.
Pregnancy, surgery and travel need advance planning. Patients should carry a diagnosis card and know which hospital to attend during a crisis.
Access and booking
Dr. Baniya consults at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, and also practises at Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital, Kathmandu, and Advanced Care Hospital. Appointments are arranged at the Durbar Marg clinic or through the respective hospital or cancer centre. Bring all blood counts, marrow, flow cytometry and molecular reports.