Neuropathic Pain in Children with Sickle Cell Disease: The Hidden Side of the Vaso-Occlusive Crisis
Jeanne Sigalla,
Nathalie Duparc Alegria,
Enora Le Roux,
Artemis Toumazi,
Anne-Françoise Thiollier,
Laurent Holvoet,
Malika Benkerrou,
Sophie Dugue,
Berengere Koehl
Affiliations
Jeanne Sigalla
Pain Management Unit, Hôpital Robert Debré, APHP, F-75019 Paris, France
Nathalie Duparc Alegria
Pain Management Unit, Hôpital Robert Debré, APHP, F-75019 Paris, France
Enora Le Roux
Unité d’Épidémiologie Clinique, Inserm, CIC 1426, Hôpital Universitaire Robert Debré, AP-HP, Nord-Université de Paris, F-75019 Paris, France
Artemis Toumazi
Unité d’Épidémiologie Clinique, Inserm, CIC 1426, Hôpital Universitaire Robert Debré, AP-HP, Nord-Université de Paris, F-75019 Paris, France
Anne-Françoise Thiollier
Pain Management Unit, Hôpital Robert Debré, APHP, F-75019 Paris, France
Laurent Holvoet
Department of Hematology, Reference Center of Sickle Cell Disease, Hôpital Universitaire Robert Debré, AP-HP, Nord-Université de Paris, F-75019 Paris, France
Malika Benkerrou
Université de Paris, ECEVE UMR 1123, Inserm, F-75010 Paris, France
Sophie Dugue
Pain Management Unit, Trousseau Hospital, AP-HP, Sorbonne Université, F-75012 Paris, France
Berengere Koehl
Department of Hematology, Reference Center of Sickle Cell Disease, Hôpital Universitaire Robert Debré, AP-HP, Nord-Université de Paris, F-75019 Paris, France
The majority of hospitalizations of patients with sickle cell disease (SCD) are related to painful vaso-occlusive crises (VOCs). Although the pain of VOC is classically nociceptive, neuropathic pain (NP) has also been demonstrated in SCD patients. The aim of our study is to specify the prevalence of NP during VOCs in SCD children using a dedicated scale and to measure its characteristics. We performed a prospective study that included SCD children hospitalized for an acute VOC. The presence of NP was sought with the DN4 scale on the second and fourth days of hospitalization. A total of 54 SCD children were included in the study. Overall, 41% of the patients (n = 22) experienced neuropathic pain during the VOC, mostly at an early stage (Day 2). The median age, the sex ratio, the location of the pain, and the morphine consumption were similar for patients with and without NP. Our study shows that neuropathic pain is very common during VOCs in SCD children. The absence of identified risk factors should prompt us to be vigilant regardless of the patient’s age, sex, and clinical presentation.