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Folic Acid Supplementation In Children With Sickle Cell Disease

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Last Updated: 18 September 2020

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General | Latest Info

Sickle cell disease is caused by an abnormal type of hemoglobin called hemoglobin S. Hemoglobin is a protein inside red blood cells that carry oxygen. Hemoglobin S changes red blood cells. Red blood cells become fragile and shape like crescents or sickles. Abnormal cells deliver less oxygen to the body's tissues. They can also easily get stuck in small blood vessels and break into pieces. This can interrupt healthy blood flow and cut down even more on the amount of oxygen flowing to body tissues. Sickle cell disease is inherited from both parents. If you get Sickle cell gene from only one parent, you will have Sickle cell trait. People with Sickle cell trait do not have symptoms of Sickle cell disease. Sickle cell disease is much more common in people of African and Mediterranean descent. It is also seen by people from South and Central America, Caribbean, and the Middle East. Symptoms usually do not occur until after the age of 4 months. Almost all people with Sickle cell disease have painful episodes called crises. These can last from hours to days. Crises can cause pain in the lower back, leg, joints, and chest. Some people have one episode every few years. Others have many episodes each year. Crises can be severe enough to require hospital stay. Younger children with Sickle cell disease have attacks of abdominal pain. Following symptoms may occur because small blood vessels become blocked by abnormal cells: Painful and prolonged erection, poor eyesight or blindness Problems with thinking or confusion caused by small strokes Ulcers on lower legs over time, spleen stops working. As a result, people with Sickle cell disease may have symptoms of infections such as: bone infection, Gallbladder infection, lung infection, urinary tract infection delay growth and puberty. Painful joints caused by arthritis, heart or liver failure due to too much iron, goal of treatment is to manage and control symptoms, and to limit number of crises. People with Sickle cell disease need ongoing treatment, even when not having a crisis. People with this condition should take folic acid supplements. Folic acid helps make new red blood cells. Blood transfusions pain Medicines Plenty of fluids hydroxyurea, which help reduce the number of pain episodes in some people. Antibiotics, which help prevent bacterial infections that are common in Children with Sickle cell disease Medicines that reduce the amount of iron in the body Newer therapies to reduce frequency and severity of pain crises have been approve treatments that may be need to manage complications of Sickle cell disease include: dialysis or kidney transplant for kidney disease Counseling for psychological complications Gallbladder removal in people with gallstone disease Hip replacement for avascular necrosis of Hip Surgery for eye Problems Treatment for overuse or abuse of narcotic pain Medicines Wound care for leg Ulcers bone marrow or stem cell transplants can cure Sickle cell disease, but this Treatment is not option for most people.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Diagnosis

Blood tests can check for defective form of hemoglobin that underlies sickle cell anemia. In the United States, this blood test is part of routine newborn screening. But older children and adults can be test, too. In adults, blood sample is drawn from a vein in the arm. In young children and babies, blood samples are usually collected from finger or heel. The sample is then sent to laboratory, where it's screened for defective hemoglobin. If you or your child has sickle cell anemia, your doctor might suggest additional tests to check for possible complications of the disease. If you or your child carries sickle cell gene, you 'll likely be referred to genetic counselor.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Treatment

In Red blood Cell transfusion, red blood cells are removed from the supply of donated blood, then given through vein to person with Sickle Cell Anemia. This increases the number of normal red blood cells, which helps reduce symptoms and complications. Risks include immune response to donor blood, which can make it hard to find future donors; infection; and excess iron buildup in your body. Because excess iron can damage your heart, liver and other organs, if you undergo regular transfusions, you might need treatment to reduce iron levels. Stem Cell transplant. Also known as bone marrow transplant, this procedure involves replacing bone marrow affected by Sickle Cell Anemia with healthy bone marrow from donor. The procedure usually uses matched donor,s such as sibling, who doesn't have Sickle Cell Anemia. Because of risks associated with bone marrow transplant, procedure is recommended only for people, usually children, who have significant symptoms and complications of Sickle Cell Anemia. Procedures require long hospital stay. After transplant, you 'll receive drugs to help prevent rejection of donated stem cells. Even so, your body might reject transplant, leading to life - threatening complications.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Lifestyle and home remedies

Taking the following steps to stay healthy may help you avoid complications of Sickle cell anemia: take folic acid supplements daily, and choose a healthy diet. Bone marrow needs folic acid and other vitamins to make new red blood cells. Ask your doctor about folic acid supplement and other vitamins. Eat a variety of colorful fruits and vegetables, as well as whole grains. Drink plenty of water. Dehydration can increase your risk of Sickle cell crisis. Drink water throughout your day, aiming for about eight glasses a day. Increase the amount of water you drink if you exercise or spend time in hot, dry climate. Avoid temperature extremes. Exposure to extreme heat or cold can increase your risk of Sickle cell crisis. Exercise regularly, but don't overdo it. Talk with your doctor about how much exercise is right for you. Use over - counter medications with caution. Use OTC pain medications, such as ibuprofen or naproxen sodium, sparingly, if at all, because of possible effect on your kidneys. Ask your doctor before taking OTC drugs. Don't smoke. Smoking increases your risk of pain crises.


Topic Overview

If you exercise strenuously, rest when you feel tired and drink plenty of fluids to prevent dehydration. Dehydration and reduced oxygen levels in person's blood resulting from strenuous exercise may cause red blood cells to sickle. Children with sickle cell disease can usually exercise and play normally if they: drink plenty of fluids before, during, and after exercise. Dehydration can cause cells to sickle. Get regular rest breaks during vigorous exercise. Stay warm. Exposure to cold air, wind, and water can trigger sickle cell crisis. Dress children in warm layers of clothing for cold - weather activities. Avoid swimming and playing in cold water.


What Is Sickle Cell Disease?

Sickle cell disease is a genetic condition. People who have it inherited certain hemoglobin genes from their parents. Hemoglobin is protein inside of red blood cells that carry oxygen. Abnormal hemoglobin makes red blood cells sickle shape. Someone who inherits sickle cell genes from each parent has sickle cell disease. Someone who inherits sickle cell gene from one parent and normal hemoglobin gene from other has sickle cell trait rather than sickle cell disease. Most people with sickle cell trait don't have symptoms, but can pass gene to their children. Someone who inherits sickle cell gene from one parent and another kind of abnormal gene from other parent may have a different form of sickle cell disease, such as hemoglobin SC disease or sickle beta thalassemia.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Coping and support

If you or someone in your family has sickle cell anemia, you might want help coping. Consider: finding someone to talk with. Ask your doctor if there are support groups for families in your area. Talking with others who are facing the same challenges you re facing can be helpful. Exploring ways to cope with pain. Work with your doctor to find ways to control your pain. Pain medications can't always take all pain away. Different techniques work for different people, but it might be worth trying heating pads, hot baths, massages or physical therapy. Learning about sickle cell anemia to make informed decisions about care. If you have a child with sickle cell anemia, learn as much as you can about the disease. Ask questions during your child's appointments. Ask your health care team to recommend good sources of information.


Home Treatment

You can help your child cope with special needs in school by: making arrangements with teachers or tutors to help your child keep pace with classmates when illness causes absences from school. Explaining to teachers that children with sickle cell disease may need to use the bathroom more often than other kids. They also need more water than other students. Not drinking enough water can raise the chance of sickle cell crisis. Educating teachers and other school employees about signs and symptoms of sickle cell disease that needs urgent medical care. Writing instructions will help school personnel know what to do and who to call in emergency. Children with sickle cell disease can usually exercise and play normally if they: drink plenty of fluids before, during, and after exercise. Lack of fluids can cause cells to sickle. Get regular rest breaks during vigorous exercise. Stay warm. Exposure to cold air, wind, and water can trigger sickle cell crisis. Dress children in warm layers of clothing for cold - weather activities. Your child should avoid swimming and playing in cold water. Folic acid supplements are often a necessary part of the diet for people with sickle cell disease, particularly if you aren't eating enough folate - rich leafy vegetables.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Main results

People with Sickle cell disease can have problems that need immediate care by a doctor, such as: acute chest syndrome: caused by inflammation, infection, and blockages of small blood vessels in the lung. Signs include chest pain, coughing, trouble breathing, and fever. Aplastic crisis: this is when the body temporarily does not make enough red blood cells, and can cause severe anemia. Signs include paleness, extreme tiredness, and fast heartbeat. Infection: People with Sickle cell disease are at risk for some bacterial infections. It's important to watch for fevers of 101F or higher, which can be signs of infection. Call your doctor and get medical care right away if a fever happens. Priapism: Guys with Sickle cell disease can have painful, long - lasting erections. If it's not treated quickly, damage can cause problems with getting erections later on. Stroke: Sickle - shaped cells can block small blood vessels in the brain, causing stroke. Signs can include headache, seizure, weakness of arms and legs, speech problems, facial droop, or loss of consciousness. People with Sickle cell disease are also at risk for problems such as leg ulcers, bone or joint damage, gallstones, kidney damage, eye damage, and delayed growth.


What Is Sickle Cell Disease?

People with sickle cell disease can have pain when blood can't get to parts of body. These times are called pain crises. Pain may happen in any part of the body and may be brought on by cold, stress, illness, or dehydration. Pain may last a few hours, few days, or sometimes longer. Sometimes pain can be managed at home. But someone with severe pain might need treatment in hospital. People with sickle cell disease often have low number of red blood cells, or anemia. Signs of anemia include: paleness, often seen on skin, lips, or nailbeds, tiredness, dizziness, being short of breath, feeling lightheaded, being irritable, trouble paying attention to fast heartbeat People with sickle cell anemia may have jaundice. This happens because sickle - shape red blood cells break down faster than normal cells.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

PLAIN LANGUAGE SUMMARY

One doubIeblind, placebocontrolled triaI on folic acid supplementation in children with SCD was included in the review. Overall, trial present mixed evidence on the review's outcomes. No trials in adults were identify. With limited evidence provide, we conclude that, while it is possible that folic acid supplementation may increase serum folate levels, effect of supplementation on anaemia and any symptoms of anaemia remain unclear. If further trials are conduct, these may add evidence regarding the efficacy of folate supplementation. Future trials should assess clinical outcomes such as folate concentration, haemoglobin concentration, adverse effects and benefits of intervention, especially with regards to SCDrelated morbidity. Such trials should include people with SCD of all ages and both sexes, in any setting. To investigate the effects of folate supplementation, trials should recruit more participants and be of longer duration, with longterm followup, than trial currently included in this review. However, we do not envisage further trials of this intervention will be conduct, and hence review will no longer be regularly update.


When Should I Call the Doctor?

If you or your child has sickle cell disease, try to find a doctor who has special training for this disease. Some medical centers and hospitals specialize in sickle cell disease treatment and support. If your local community doesn't offer this option, look for a doctor and pain treatment specialist who has experience of treating sickle cell disorders. Choose a doctor you are comfortable with and can partner with over the long term. Following types of health professionals can diagnose and help treat symptoms of sickle cell disease. Some of these health professionals may provide specialized treatment or counseling.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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