Sickle Cell Hepatic Vaso‐Occlusive Crisis: A Case Report

Sickle cell disease (SCD) is an inherited hemoglobinopathy caused by a point mutation in the β‐globin gene, resulting in hemoglobin S polymerization under hypoxic conditions. This process leads to erythrocyte dehydration, impaired deformability, hemolysis, and recurrent vaso‐occlusion, which may culminate in acute painful crises and progressive organ damage. Hepatic involvement is a recognized but underreported complication of SCD and can range from mild biochemical abnormalities to life‐threatening hepatic vaso‐occlusive crisis (VOC). This case report presents a 25‐year‐old woman, with homozygous sickle cell anemia who developed a rapidly progressive hepatic VOC following a mild respiratory illness. Her clinical course was marked by acute abdominal pain, severe transaminitis, cholestasis, escalating transfusion requirements, and radiologic evidence of hepatomegaly. Clinical and biochemical improvement was observed following a multimodal management approach that included supportive care, corticosteroids, blood transfusion, and the addition of intravenous metronidazole. This case highlights hepatic VOC as a serious manifestation of SCD and explores the potential role of metronidazole as an adjunctive therapy, given its immunomodulatory and anti‐inflammatory properties. Further investigation is warranted to clarify its therapeutic role in sickle cell–related vaso‐occlusive complications.