Low-dose Warfarin May Be a Life-saving Treatment Regimen in Sickle Cell Diseases

The sickled or just hardened red blood cells (RBCs)-induced capillary endothelial damage initiates at birth, and terminates with multiorgan failures and sudden deaths even at childhood.

Although RBCs suspensions and corticosteroids in acute, and aspirin plus hydroxyurea both in acute and chronic phases decrease severity, survivals are still shortened in both genders, dramatically. Infections, medical or surgical emergencies, or emotional stress induced increased basal metabolic rate accelerates sickling, and an exaggerated capillary endothelial edema-induced myocardial infarction or stroke may
cause sudden deaths.

Lifelong aspirin with an antiinflammatory dose plus low-dose warfarin may be life-saving even at childhood both to decrease severity of capillary endothelial inflammation and to prevent thromboembolic complications in the SCDs.