Changes in objective signs during the evolution of the sickle cell painful crisis
| Podromal phase . | Initial phase . | Established phase . | Resolving phase . |
|---|---|---|---|
| Decreasing | Decreasing | Peak | Peak |
| RBC deformability | RBC deformability | Temperature | Fibrinogen |
| Platelets | WBC count | Orosomucoid | |
| Increasing | Dense cells | ESR | |
| Dense RBC | Increasing | ISC | |
| Temperature | RDW | Decreasing | |
| WBC count | HDW | Temperature | |
| Dense cells | Reticuloytes | WBC count | |
| ISC | LDH | Dense cells | |
| RDW | CRP | ISC | |
| HDW | SAA | RDW | |
| ESR | HDW | ||
| LDH | Nadir | CRP | |
| CRP | RBC deformability | ||
| Fibrinogen | Hb | Increasing | |
| Orosomucoid | RBC deformability | ||
| SAA | Increasing | Plasma viscosity | |
| Fibrinogen | Platelets | ||
| Orosomucoid | |||
| Plasma viscosity | |||
| ESR |
| Podromal phase . | Initial phase . | Established phase . | Resolving phase . |
|---|---|---|---|
| Decreasing | Decreasing | Peak | Peak |
| RBC deformability | RBC deformability | Temperature | Fibrinogen |
| Platelets | WBC count | Orosomucoid | |
| Increasing | Dense cells | ESR | |
| Dense RBC | Increasing | ISC | |
| Temperature | RDW | Decreasing | |
| WBC count | HDW | Temperature | |
| Dense cells | Reticuloytes | WBC count | |
| ISC | LDH | Dense cells | |
| RDW | CRP | ISC | |
| HDW | SAA | RDW | |
| ESR | HDW | ||
| LDH | Nadir | CRP | |
| CRP | RBC deformability | ||
| Fibrinogen | Hb | Increasing | |
| Orosomucoid | RBC deformability | ||
| SAA | Increasing | Plasma viscosity | |
| Fibrinogen | Platelets | ||
| Orosomucoid | |||
| Plasma viscosity | |||
| ESR |
Parameters shown are those reported at least twice by different investigators.
ISC indicates irreversibly sickled cells; WBC, white blood cells; RDW, red cell distribution width; HDW, hemoglobin distribution width; ESR, erythrocyte sedimentation rate; LDH, lactate dehydrogenase; CRP, C-reactive protein; and SAA, serum amyloid A.
Data from Ballas with permission.44