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Ronald L. Nagel, MD

JAMA. 2001;286:2152-2153.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Acute painful crisis in sickle cell disease is a frequent complication and considerably diminishes the quality of life of patients with this disease.¹ The pain of sickle cell crisis is one of the most intense in medicine—it has been compared with that of a severe toothache—and affects the extremities, abdomen, lower back, or multiple sites simultaneously. The unpredictability of such painful episodes adds to their discomfort.

Some major precipitating factors and aggravating circumstances that contribute to the complex pathophysiology of acute painful crisis include infection, dehydration, excessive exercise,² emotional disturbances, or stressful environments. Furthermore, lack of prompt and individualized acute pain treatment increases hospitalization rates as well as the duration and intensity of painful episodes.^3-4

Even though sickle cell disease was discovered in 1910⁵ and defined at the molecular level in the 1950s,^6-7 it was not until 1995 that a proven ameliorating therapy was discovered. In . . . [Full Text of this Article]

Author Affiliation: Division of Hematology, Albert Einstein College of Medicine/Montefiore Hospital, Bronx, NY.

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