Other specialities
Cardiac complications are common. We are fortunate in having two cardiologists with a special interest in this area. Dr Malcolm Walker, an internationally recognised expert, and Dr David Brull, are increasingly involved in research in this area.
People with thalassaemia or sickle cell develop a variety of problems, some of which are directly related to the treatments. Some problems, such as sarcoid are indirectly linked but can present as an unexplained exacerbation of the underlying problem. In sickle cell patients, renal impairment is likely to be an increasingly frequent problem as the population ages. The renal service at the Royal Free has direct links with our service; Dr Robin Woolfson works at both Trusts and has a particular interest in the problems of renal failure in people with sickle cell.
Mr Minhas at UCLH has a special interest in Priapism, one problem that can become an acute emergency. Whilst the PISCES study is looking at this problem and may reveal new ways of managing this, it is worthwhile to know that in an emergency we have a protocol using existing data.
Bone and joint complication are the most common cause of chronic pain in sickle cell sufferers. Patients may suffer as rarely as once a year or as often as once a week. Many patients suffer from the long-term consequences, leading to chronic joint pain. Changes in thoracic and lumbar spine, infection, bone marrow disturbances and dental effects are all part of the complications that may occur at any location. The location and the extensiveness of the problem determine the pain and damage for the patient, whilst the hip joint is particularly vulnerable in sickle cell disease.
It is important for patient’s bone and joint concerns to be assessed by medical teams as a complication separate to their disease and treated for this, which is why we work closely with out rheumatology team to ensure best care for patients particular needs. There is also some evidence that SLE is more common in people with sickle cell; this can lead to diagnostic confusion and management problems.
People with thalassaemia or sickle cell develop a variety of problems, some of which are directly related to the treatments. Some problems, such as sarcoid are indirectly linked but can present as an unexplained exacerbation of the underlying problem. In sickle cell patients, renal impairment is likely to be an increasingly frequent problem as the population ages. The renal service at the Royal Free has direct links with our service; Dr Robin Woolfson works at both Trusts and has a particular interest in the problems of renal failure in people with sickle cell.
Mr Minhas at UCLH has a special interest in Priapism, one problem that can become an acute emergency. Whilst the PISCES study is looking at this problem and may reveal new ways of managing this, it is worthwhile to know that in an emergency we have a protocol using existing data.
Bone and joint complication are the most common cause of chronic pain in sickle cell sufferers. Patients may suffer as rarely as once a year or as often as once a week. Many patients suffer from the long-term consequences, leading to chronic joint pain. Changes in thoracic and lumbar spine, infection, bone marrow disturbances and dental effects are all part of the complications that may occur at any location. The location and the extensiveness of the problem determine the pain and damage for the patient, whilst the hip joint is particularly vulnerable in sickle cell disease.
It is important for patient’s bone and joint concerns to be assessed by medical teams as a complication separate to their disease and treated for this, which is why we work closely with out rheumatology team to ensure best care for patients particular needs. There is also some evidence that SLE is more common in people with sickle cell; this can lead to diagnostic confusion and management problems.
Dr Rekha Bajoria
Dr Bajoria, MRCOG, MRCP, PhD, has recently been appointed as a Clinical Senior Lecturer in Medical Education at UCL to facilitate the setting up and running of an e-MSc course in haemoglobinopathy, led by Dr Chatterjee. Dr Bajoria has been trained in the Imperial School and has worked in Manchester, Newham and North Middlesex Hospital. She is interested in obstetric and fertility aspects of haemoglobinopathies and has been involved with the Whittington and UCLH group in clinical and basic science research related to thalassaemia.
Dr David Brull
David has worked with Malcolm Walker in the past and is now based at the Whittington Hospital. He has an interest in the cardiac problems in people with haemoglobinopathies and hopes over the coming years to expand the local services available for haemoglobinopathy patients.more
Dr Ratna Chatterjee
Based at UCLH, Dr Chatterjee has a special interest in the endocrine problems of people with haemoglobinopathies and with iron overload. She did her PhD in growth and sexual development and hypothalamic-pituitary axis in patients with thalassaemia syndrome at UCL. She is a clinical senior lecturer and consultant in chronic and serious disease in the Institute for Women’s Heath at UCLH and UCL and is an international expert in endocrine problems of haemaoglobinopathy. Fertility problems are a special interest and there is a unique multidisciplinary service for iron overloaded people with endocrine problems including delayed growth and sexual development and osteoporosis. She is leading the establishing of new global e-MSc course in haemoglobinopathies at UCL.
Dr Sara Lock
Dr Sara Lock is a respiratory physician at the Whittington. People with sickle cell are prone to a number of respiratory problems including chronic lung disease, secondary to episodes of sickle lung, that can cause respiratory failure i.e. hypoxia which may be most notable at night, also tuberculosis, sarcoidosis and chronic lung infections. Other conditions, which cause hypoxia, such as obstructive sleep apnoea, should be considered as this will promote sickle cell crises.more
Dr Malcolm Walker
Dr Malcolm Walker is based at University College London Hospital and has a special interest in the arrythmias and heart failure problems that people with haemoglobinopathies experience. He has worked with colleagues for several years and cases of heart failure due to iron overload that would once have been considered an end-stage disease are now routinely recovered; he has an international reputation for this work.
Dr Ihuoma Wamuo
Dr Ihuoma Wamuo is a consultant rheumatologist and general physician. She runs general rheumatology clinics seeing patients who have arthritis and has set up a lupus clinic, which runs once a month. Dr Wamuo developed an interest in sickle cell anaemia and its relationship with rheumatology.more
Dr Robin Woolfson
Dr Robin Woolfson works at the Royal Free Hospital and the Whittington. He is a nephrologist who has become increasingly interested in the renal problems experienced by those with haemoglobinopathies, this includes renal tubular acidosis, which may become a more significant problem when the patients are sick with other illnesses and issues such as glomerulopathy and proteinuria. Cooperation between haematologists and nephrologists may reduce the risk of progression of some of these problems.more
Last updated04 Mar 2008