Sickle Cell anemia with Hypertension

A 10 yr old child ,k/c/o Sickle cell anemia presented with c/o Fever since 5 days. O/E pallor +++, Periorbital edema +, Afebrile, Tachypoic, abdoment moderately distended, hepatosplenomegaly +. BP -170/110, Investigations- hb 4.5, wbc normal, s.albumin- 3.15, S.creatinine-0.5, s.urea 26, usg -hepatosplenomegaly , thick walled gall blades with mild ascites and b/l pleural effusion. Antibiotics , 3blood transfusion given,Lasix started . Kindly suggest further management

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Possibility of splenic sequestration and portal htn. Fluid management with BP control needed Academia should be on focus. Anticoagulant to prevent embolus complication Respiratory support may be needed Echo is needed to rule out pulmonary htn which make thing irreversible and tachypnea is a indicator here

Thank you doctor
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Check for Dengue Serology . Get sepsis work up done. 2-D echo to rule out ? Kawasaki like illness .

Start Oxygen support . Monitor urine output , saturation , sensorium , BP . Get ABG done to look for metabolic acidosis ( in case of sepsis), Send urine routine & blood culture , crp .
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