PMID- 31454562

OWN - NLM
STAT- Publisher
LR - 20190827
IS - 1872-7972 (Electronic)
IS - 0304-3940 (Linking)
DP - 2019 Aug 24
TI - Neuropathic pain in individuals with sickle cell disease.
PG - 134445
LID - S0304-3940(19)30548-8 [pii]
LID - 10.1016/j.neulet.2019.134445 [doi]
AB - Pain is the most frequently occurring complication of sickle cell disease
(SCD)
and the leading cause of hospitalizations for affected individuals. Acute
pain
episodes are also an independent predictor of mortality in individuals with
SCD.
The pathophysiology of pain in SCD is complex and has been attributed to
several
biologic factors, including oxidative stress, vaso-occlusion,
ischemia-reperfusion injury and inflammation. In spite of this complex
biology,
painful events requiring hospitalization are simplistically referred to as
"acute
vaso-occlusive pain episodes" by the hematology community, and subgroups of
pain
in SCD have not been formally classified. Neuropathic pain is an emerging
unique
SCD pain phenotype that could be a result of these biologic drivers in SCD.
Neuropathic pain is caused by a lesion or disease of the somatosensory
nervous
system and has been estimated to occur in approximately 25-40% of adolescents
and
adults with SCD. Diagnostic modalities for neuropathic pain, including
validated
questionnaires incorporating pain descriptors, quantitative sensory testing
and
functional neuroimaging, have been evaluated in small to medium-sized
cross-sectional studies of adolescents and adults with SCD. However, these
diagnostic tests are not currently used in the routine care of individuals
with
SCD. Age, female gender and hydroxyurea use have been reported to be
positively
associated with neuropathic pain in SCD, although modifiable risk factors for
the
prevention of neuropathic pain in this population have not been identified. A
few
early phase studies have begun to investigate neuropathic pain-specific
medications in individuals with SCD. However, evidence-based strategies to
target
neuropathic pain in SCD are lacking, and the existing literature suggests
that
neuropathic pain-specific medications are highly underutilized in individuals
with SCD. We will review the epidemiology, underlying biology and therapeutic
interventions for diagnosis and treatment of neuropathic pain in SCD. We will
also highlight opportunities to address critical gaps in knowledge that
remain
for this under-recognized cause of SCD morbidity.
CI -
Copyright (c) 2019. Published by Elsevier B.V.
FAU -
Sharma, Deva
AU -
Sharma D
AD -
Division of Transfusion Medicine, Nashville, TN, United States; Vanderbilt
University Medical Center, Nashville, TN, United States. Electronic address:
devaji@gmail.com.
FAU - Brandow, Amanda M
AU - Brandow AM
AD - Section of Pediatric Hematology/Oncology, Milwaukee, WI, United States;
Medical
College of Wisconsin, Milwaukee, WI, United States; Children's Research
Institute
of the Children's Hospital of Wisconsin, Milwaukee, WI, United States.
LA - eng
PT - Journal Article
PT - Review
DEP - 20190824
PL - Ireland
TA - Neurosci Lett
JT - Neuroscience letters
JID - 7600130
SB - IM
OTO - NOTNLM
OT - neuropathic pain
OT - sickle cell disease
EDAT- 2019/08/28 06:00
MHDA- 2019/08/28 06:00
CRDT- 2019/08/28 06:00
PHST- 2018/11/26 00:00 [received]
PHST- 2019/06/06 00:00 [revised]
PHST- 2019/08/20 00:00 [accepted]
PHST- 2019/08/28 06:00 [entrez]
PHST- 2019/08/28 06:00 [pubmed]
PHST- 2019/08/28 06:00 [medline]
AID - S0304-3940(19)30548-8 [pii]
AID - 10.1016/j.neulet.2019.134445 [doi]
PST - aheadofprint
SO - Neurosci Lett. 2019 Aug 24:134445. doi: 10.1016/j.neulet.2019.134445.