Joseph Mattana, MD; Pravin C. Singhal, MD
To the Editors: Valeriano-Marcet and Kerr (1) report myonecrosis and myofibrosis in four patients with painful crises of sickle cell disease. Presumably, sickling of red blood cells causes muscle ischemia and infarction, which account for the musculoskeletal pain that patients with sickle cell disease experience.
Creatine kinase is a major biochemical marker of muscle-cell injury; however, the investigators reported a creatine kinase value for only one of their patients. This patient showed only a mildly elevated creatine kinase level, which is not what one would expect in the setting of significant myonecrosis and which easily could have been a consequence
Mattana J, Singhal PC. Myonecrosis and Myofibrosis in Sickle Cell Anemia. Ann Intern Med. ;115:830–831. doi: 10.7326/0003-4819-115-10-830
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Published: Ann Intern Med. 1991;115(10):830-831.
Hematology/Oncology, Red Cell Disorders.
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