A Review of Clinical Profile in Sickle Cell Traits

Abstract

Sickle cell trait is not usually regarded as a disease state because it has complications that are either uncommon or mild. Nevertheless, under unusual circumstances, serious morbidity or mortality can result from complications related to polymerization of deoxy-hemoglobin S. A previous study was earlier conducted to study Sickle cell traits and it revealed that there was enhanced lipid per oxidation along with imbalance in the pro-oxidant and antioxidant status in patients with sickle cell anaemia. Moreover, sickle cell traits present with varied problems including increased urinary tract infection in women, gross hematuria, complications of hyphema, splenic infarction with altitude hypoxia or exercise, life-threatening complications of exercise etc. Renal medullary carcinoma in the young, early onset of end stage renal, as well as disease from autosomal dominant polycystic kidney disease are other well-known occurrences in sickle cell traits. In view of the above facts, this article aims to review the literature to analyze the health status in sickle cell traits.

Sickle Cell Trait: A Benign State?

“…An important implication of SCT as a risk factor for ESRD is a decision on whether to use these individuals as donors for kidney transplant. Renal medullary carcinoma is also more prevalent than renal cell carcinoma in SCT patients when compared with non-SCT individuals [8,23] .…”

“…Deletion of one or two chains in an individual with SCT is associated with a better concentrating ability of the kidney [23] since this reduces the percentage concentration of HbS. Micro infarcts occurring in the renal medulla as a result of extreme hypoxia, acidosis or hypertonicity may be responsible for the inability to concentrate urine, while the corresponding papillary necrosis may result in microscopic hematuria [23] and sometimes in gross hematuria. It has been suggested that SCT may not be responsible for the observed papillary necrosis and hematuria since it could also occur in people without the trait [23] .…”

“…Micro infarcts occurring in the renal medulla as a result of extreme hypoxia, acidosis or hypertonicity may be responsible for the inability to concentrate urine, while the corresponding papillary necrosis may result in microscopic hematuria [23] and sometimes in gross hematuria. It has been suggested that SCT may not be responsible for the observed papillary necrosis and hematuria since it could also occur in people without the trait [23] . Among patients with end-stage renal disease (ESRD), the prevalence of SCT was found to be higher in studies done in African Americans, thus making SCT a possible risk factor for ESRD [8,24] .…”

Sickle cell trait in orthopaedic surgery: A real issue or just a bogeyman

“…Due to the almost completely asymptomatic nature of the condition sickle cell trait is generally a laboratory diagnosis. Hemoglobin levels, red cell morphology, red cell indices, and the reticulocyte count are entirely normal in patients with sickle cell trait [7], and irreversibly sickled cells (ISCs) are not normally present in the peripheral blood smear. The diagnosis of sickle cell trait is made by demonstrating the presence of significant quantities of HbS.…”

Sickle Cell Trait Appears to Increase the Risk of Hemorrhagic Stroke in African Adults with Dyslipidaemia: A Pilot Study

“…Therefore, stroke was not considered to be associated with sickle cell trait. Also, there has not been any significant difference in the outcomes of stroke for sickle cell patients compared with normal haemoglobin [19]. In order to shed more light on this debatable association, a 24-year prospective epidemiological study was recently conducted observing an increased risk of ischaemic stroke in blacks with sickle cell trait [20].…”