Recurrence of acute chest syndrome post stopping Crizanlizumab, the dilemma of stopping vs continuation in patient with sickle cell disease: case report

Sickle cell disease (SCD) is one of the most common hematological diseases, which results in variable complications. The treatment of SCD is evolving but limited options are available for now. Acute chest syndrome (ACS) is one of the serious complications observed in SCD and a challenging one in prevention. Crizanlizumab is a monoclonal antibody that binds to P-selectin and improves blood flow by preventing sickle cell adhesion to endothelium, resulting in improvement of vaso-oclusive crises (VOC). It is not well evaluated in terms of ACS prevention. Here we report a 23-year-old patient with SCD and recurrent ACS; she was started on Crizanlizumab and she had no more ACS, but once she was off Crizanlizumab she developed ACS again, later Crizanlizumab was re-started, and the patient has improved significantly.

Automated summary

Sickle cell disease (SCD) is a common hematological disease with various complications. The treatment options for SCD are limited. Acute chest syndrome (ACS) is a challenging complication in SCD prevention. Crizanlizumab, a monoclonal antibody, improves blood flow in SCD patients by preventing sickle cell adhesion to endothelium. However, its effectiveness in ACS prevention is not well evaluated. This case report presents a 23-year-old SCD patient with recurrent ACS who showed significant improvement when treated with Crizanlizumab.