{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T20:25:24Z","timestamp":1789503924701,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2003,2,25]],"date-time":"2003-02-25T00:00:00Z","timestamp":1046131200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2003,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Anemia is a major cause of morbidity and mortality among patients with sickle cell anemia. In this study, 108 episodes of severe anemia were prospectively evaluated in 108 patients with hemoglobin SS disease attending the pediatric sickle cell clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria. Young children between the ages of 2 and 4 years were found to be at the greatest risk of developing anemic crises (severe anemia). There was a gradual but progressive decline in the incidence of severe anemia in the age range 8\u201316 years old. Upper respiratory tract infections are the most commonly associated infections in patients with severe anemia. Others included malaria, septicemia, urinary tract infection, acute chest syndrome, and osteomyelitis. Their role in precipitating episodes of severe anemia among the patients studied could not be fully evaluated. Pallor, jaundice, and fever were the most commonly encountered symptoms in patients with severe anemia on admission. About half of the parents\/guardians failed to notice severe anemia among the patients studied, perhaps due to the dark color of the African skin. Caregivers need to be educated on how to recognize anemia among patients with sickle cell anemia when they develop febrile episodes. Am. J. Hematol. 72:185\u2013191, 2003. \u00a9 2003 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ajh.10285","type":"journal-article","created":{"date-parts":[[2003,3,18]],"date-time":"2003-03-18T23:06:31Z","timestamp":1048028791000},"page":"185-191","source":"Crossref","is-referenced-by-count":17,"title":["Clinical presentation of severe anemia in pediatric patients with sickle cell anemia seen in Enugu, Nigeria"],"prefix":"10.1002","volume":"72","author":[{"given":"A.I.","family":"Juwah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Nlemadim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Kaine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,2,25]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1910.00050330050003"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(26)90485-9"},{"key":"e_1_2_1_4_2","first-page":"194","article-title":"The diagnosis and management of sickle cell","volume":"9","author":"Nwokolo C","year":"1960","journal-title":"West Afr Med J"},{"key":"e_1_2_1_5_2","first-page":"742","article-title":"Sickle cell anemia in Eastern Nigeria: a detailed analysis of 210 cases","volume":"59","author":"Kaine WN","year":"1982","journal-title":"E Afr Med J"},{"issue":"3","key":"e_1_2_1_6_2","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1080\/02724936.1987.11748503","article-title":"Acute illness in Nigerian children with sickle cell anemia","volume":"7","author":"Akinyanju O","year":"1987","journal-title":"Ann Trop Paediatr"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/38.2.83"},{"key":"e_1_2_1_8_2","first-page":"629","article-title":"Studies on congenital hemolytic syndromes. 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