Avascular Necrosis (associated with Sickle Cell Anaemia and ß Thalassemia minor) Management through Ayurveda - A Case Report

Abstract

Avascular Necrosis (AVN) of femoral head is one of the frequent and most debilitating complications in children suffering from Sickle Cell Anemia and ß-Thalessemia minor. AVN in Sickle Cell Anemia is prevalent in approximately 3% of children under age group 15, 8.7%-12.4% by age 21 and progressing to values higher than 50% in population over 35age group. AVN is associated with pain and reduction of Range of Motion. Samprapti (Pathogenesis) of this anuktavyadhi (unmentioned disease) in Ayurveda texts can be understood, based on Ayurvedic Principles as Khavaigunya→Avarana→Raktakshaya→Vataprakopa→Asthimajjakshaya, finally leading to the clinical condition similar to AVN. Limitation of AVN treatment is surgery, offers hip joint replacement of only 15-20 years life which is not so commonly available and expensive too. Ayurveda offers a suitable answer to AVN through Panchakarma procedures and Shamana Chikitsa, check the progression, reduce and reverse the disease process and improves quality of life of the patient. A male patient aged 16 years suffering from bilateral AVN with Sickle Cell Disease (SCD) and ß-Thalassemia minor was treated with Deepana-Pachana, Virechana, and Kala Basti followed by Shamana and Rasayana Chikitsa. The assessment was done on Harris Hip Scale (HHS),Visual Analogue Scale (VAS) and Depression Anxiety Stress Scale (DASS), patient had symptomatic improvements and specific changes on above scales. Ayurvedic Management provided marked relief from pain, tenderness, stiffness and improvement in gait.