Clinical History Patient: 37-year-old man of half African and half Italian ethnicity.
Chief Complaint: Sickle cell crisis (SCC).
History Of Present Illness: The patient had severe pain in his lower back that radiated to both thighs. He had been admitted twice in the previous 2 weeks at another hospital due to SCC. Each time, he had been discharged with a prescription for oxycodone. His condition did not respond to the pain medicine; his pain remained uncontrollable.
Medical History: The patient has had multiple sickle cell crises since childhood and is a former smoker. He denied alcohol consumption or illegal drug use.
Physical Examination Findings: The patient had normal vital signs. No splenomegaly was present.
Family History: Both parents carry sickle cell thalassemia.
Principal Laboratory Findings: Table 1, Table 2, and Image 1.
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