CME Article: Medical Neglect by Underprescription and Underutilization of Hydroxyurea in Children with Sickle Cell Disease

Authors: Sohail Rana, MD


More than 20 years ago, I prescribed hydroxyurea (HU) for the first time. Derrick was 17 and had been admitted more than 50 times for severe pain crises. Brought in severe pain to the hospital by ambulance, he would receive intravenous fluids and narcotics for several days and then finally be able to walk and be discharged home. He would miss more than a week of school with each episode, and he was two grades behind because of repeated hospitalizations. Following the publication of the Multicenter Study of Hydroxyurea (MSH)1 results, I prescribed HU for Derrick. I did not see Derrick for several months; he had not been admitted and I wondered if he ever started taking HU. At the next visit he was looking well and reported that he had not had any pain and had not missed any days of school. I studied him for the next 2 years; he was never admitted during that time and he graduated from high school.

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