Low Molecular Weight Dextran in Sickle-Cell Crisis

Abstract

Effective therapy for the painful crises of the sickle-cell disease states has been energetically sought for many years. Measures previously advocated have included sodium bicarbonate,¹anticoagulants,²carbon monoxide inhalation,³and acetazolamide.⁴All have to provide little or no benefit when tested under controlled conditions.^5-8Recently, it has been reported^9,10that infusions of low molecular weight dextran have been successful in terminating these painful crises in several patients. Because objective evaluation of therapy in such individuals is notoriously difficult, we have studied the use of this agent in 11 patients under the controlled conditions of a doubleblind study. We have been unable to attribute any therapeutic effect to the dextran preparation. <h3>Materials and Methods.—</h3> All patients, thought to be having pain secondary to one of the sickle-cell disorders who presented at the emergency rooms of the Hospital of the University of Pennsylvania and the St. Christopher's Hospital