Fat Embolism in Sickle-Cell Disease: A Case Report with Literature Review

Abstract

Background: Sickle cell disease (SCD) is associated with an under-recognized and well-known complication of bone marrow necrosis known as cerebral fat embolism (CFE). Case Presentation: We report a case of successfully treated SCD patient suffering from non-traumatic cerebral fat embolism (NCFE) who came with initial manifestation of localized pain followed by loss of consciousness and absence of cardiac shunt. This was an unusual case of fat embolism in SCD patient with the absence of right-to-left cardiac shunt indicating the biochemical etiology. Patient initially showed localized pain followed by loss of consciousness, suggesting that any such initial manifestation in patient of SCD should be suspected for CFE. MRI served as an accurate diagnostic tool showing the characteristic neuroradiologic sign. Treatment with exchange-transfusion recovered the patient successfully. Conclusion: Overall, this case suggested that prompt diagnosis using MRI and treatment with RBC exchange could lead to better outcomes in SCD patients suffering from CFE.

Keywords

• cerebral fat embolism
• sickle-cell disease
• starfield appearance
• non-traumatic cerebral fat embolism