Annals of Internal Medicine: Clinical Cases (Nov 2023)

Cerebral Fat Embolism in a Patient With Hemoglobin SC Disease Associated With Vaso-Occlusive Crisis and COVID-19

  • Zachary Buxo,
  • Astha Saini,
  • Cullen Hudson,
  • Diane L. Levine

DOI
https://doi.org/10.7326/aimcc.2023.0587
Journal volume & issue
Vol. 2, no. 11

Abstract

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Sickle cell disease is characterized by episodic vaso-occlusive events triggered by a combination of inflammation, increased adhesion to vascular endothelial cells, and activation of hemostasis. This vascular obstruction results in acute vaso-occlusive pain, stroke, and acute chest syndrome, which are more commonly observed when patients are admitted for acute vaso-occlusive crisis. Although fat embolism syndrome is most associated with orthopedic trauma, individuals with sickle cell hemoglobinopathy are at increased risk for nontrauma-related fat embolism syndrome. Here we describe a young woman with a history of hemoglobin SC disease who presented with fat embolism syndrome following a vaso-occlusive crisis precipitated by COVID-19 infection.