Neuropathic Pain and Clinical Sensory Testing in Young Patients with Sickle Cell Disease

Abstract

Abstract Background The pathophysiology of pain in sickle cell disease (SCD) is complex and not fully understood. Neuropathic pain (NP) is an emerging theory of chronic pain in SCD. Nevertheless, assessment of NP is not a part of standard care of patients with SCD. Aim and Objectives To study the frequency of neuropathic pain among young patients with SCD by ID-P questionnaire and Clinical Sensory Testing (CST). Patients and Methods In this cross-sectional study Patients with SCD were recruited and data were collected on sociodemographic and clinical criteria of the disease. ID Pain (ID-P) questionnaire was used as a screening tool for NP. We performed a bedside clinical sensory testing (CST) including cold, warm, and pressure detection, cold, heat, mechanical and pressure pain threshold. Results Fifty-six participants were screened for eligibility and twelve of them were excluded; ten had stroke and two patients were diabetic. A total of 44 participants (25 males and 19 females) were included, their mean age was 12.4 years (SD 4.8; range 5.9-25 years). Screening of NP using the ID-P questionnaire revealed that 22.7% of the study cohort likely had NP. On the other hand, 34% of the participants had abnormal CST; 10 patients (22.7%) had abnormal mechanical pain threshold, 6 (13.6%) showed abnormal cold pain threshold, 2 (4.5%) had abnormal heat pain threshold and 2 (4.5%) with abnormal pressure threshold, while only one patient had delayed cold detection. Conclusion Neuropathic pain, as assessed by ID-P questionnaire and CST, is not uncommon in young patients with SCD.