“…However, more recent and detailed studies have revealed that two forms of SCD exist in Saudi Arabs, one with a mild course and another with a severe course, similar to that encountered in other populations [14,15]. Significant clinical diversity has been demon strated in disease severity in the different regions of Saudi Arabia and other Middle-Eastern countries [3,[19][20][21], Sev eral genetic and/or environmental factors have been pro posed to account for the heterogeneity of disease presen tation. Interactions between Hb S and other abnormal genes have been considered as possible modulators of the clinical manifestations of SCD [7,9,11], In an attempt to investigate and compare the clinical and haematological presentation of SCD in the different regions of Saudi Arabia and the influence of coexisting aand (l°-thalassaemia, this study was conducted on individ uals identified as Hb S homozygotes during screening of three areas of Saudi Arabia.…”