Study Identifies Features of Neuropathic Pain in SCD Patients

Patients with sickle cell disease (SCD) may suffer from neuropathic pain, especially if they are 19 years or older, use hydroxyurea as an SCD treatment and show changes in their sensory capacity, a new study says.

Researchers are calling for screenings of neuropathic pain because it may lead to faster, more effective diagnoses and, consequently,  appropriate treatments.

These findings were published in the journal Annals of Hematology with the title “Neuropathic Pain In Patients With Sickle Cell Disease: A Cross-Sectional Study Assessing Teens And Young Adults.”

Pain is the most frequent symptom associated with SCD. Episodes of acute pain in these patients vary, with an average of one to three per year, and may disappear spontaneously after a certain time.

Neuropathic pain (NP) is a form of chronic pain that results from damage to sensory nerves. According to the authors, 20% of SCD patients experience NP, especially women and older people. However, the neurobiological mechanisms responsible for NP are poorly understood, which limits clinicians’ abilities to measure and evaluate patients’ pain.

The objective of this study was to investigate the occurrence and characteristics of NP in patients with SCD. To do so, researchers followed 56 patients (average age 20.6 years old), who were divided into two groups according to whether they had NP or not.

All patients reported an occasional presence of mild pain, treated at home with analgesic drugs. Most patients (53.6%) complained of pain in the lower back area, but patients also reported pain in the abdomen (12.5%), hip (8.9%), legs (8.9%), head (7.1%), feet (3.6%), joints (3.6%), and arms (1.8%).

Fourteen SCD patients (25%) had NP. Age was found to be correlated with NP. The average age among patients with NP was 22.7 years, and 19.8 years in SCD patients without NP. Importantly, NP incidence was higher among patients aged 19 or older, compared to younger teens.

Use of hydroxyurea and sensitive neurological changes also were correlated with NP.

“It was possible to identify 25% of patients with NP among patients with SCD and SC … with adults and hydroxyurea users affected more frequently,” researchers wrote. “Sensory research through targeted physical examination increases the ability to identify NP carriers … Unfortunately, none of the identified patients had any treatment for NP. Therefore, screening for NP with the help of questionnaires may result in faster and more effective diagnoses, allowing patients to receive the right treatment with potentially fewer complications.”