What is Sickle Cell Disease?

What is Sickle Cell Disease? 2022-08-31T11:01:37-04:00

What is Sickle Cell Disease?

Sickle Cell Disease describes is a group of inherited red blood cell disorders. Normal red blood cells are round like doughnuts, and they move through the small blood tubes (blood vessels) in the body to deliver oxygen. Sickle red blood cells become hard, sticky and shaped like crescent moons or sickles, which are used to cut wheat. When these hard and pointed red cells go through the small blood vessels, they clog the flow and break apart, which can cause pain, damage to the organs that they are running through, and a low red blood cell count, or anemia.

What makes the red cell sickle?

There is a protein in the red cell called hemoglobin that carries oxygen inside the cell. One little change in this protein causes the hemoglobin to form long rods in the red cell when it is stressed, such as when there is low oxygen levels, fever or dehydration . These rigid rods give the red cell a sickle shape instead of the round shape:

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 Sickle Cell Disease is caused when the patient inherits one gene for the disease from both parents: mother and father. Sickle Cell trait occurs when the individual inherits one gene from one of his or her parents (either mother or father, but not from both). Sickle Cell Disease and Sickle Cell trait are both inherited conditions and cannot be ‘caught’. If you have Sickle Cell Disease or Sickle Cell Trait you will have it for all your life, unless you have treatments that changes your genes, such as a bone marrow transplant.
There are three common types of sickle cell disease in the United States.

    • Hemoglobin SS or sickle cell anemia
    • Hemoglobin SC disease
    • Hemoglobin Sickle beta-thalassemia

Each of these can cause sickle pain episodes and complications, but some are more common than others and some cause more severe disease than others. All of them may also be associated with an increase in fetal hemoglobin, which can reduce how much the red cell sickles and in this way help prevent complications. The medication hydroxyurea also increases fetal hemoglobin. 

Complications from the sickle cells blocking blood flow and early breaking apart include:

  • Low red blood cell counts, called anemia
  • Yellow eyes or jaundice
  • Pain episodes
  • Stroke
  • Increased risk of infection
  • Bone damage, including damage to hips and shoulders thinning of the bone, called avascular necrosis
  • Gallstones at a young age
  • Lung disease, called acute chest syndrome
  • Kidney disease, called nephropathy
  • Nighttime bedwetting, called enuresis
  • Painful erections in boys and men called priapism
  • Blood blockage in the spleen or liver called sequestration
  • Eye damage, called retinopathy
  • Delayed growth and development
  • Leg ulcers
  • Difficulty having children
A patient with sickle cell disease should be under the care of doctors and other providers who understands sickle cell disease. All newborn babies with sickle cell disease should be started on daily penicillin to help reduce the risk of serious infections. All of the childhood immunizations should be given plus other vaccines to protect against certain bacteria can cause serious infections in those with sickle cell disease. Parents should know how to check for a fever because this signals the need for an urgent medical checkup to look for a serious infection. The following are general guidelines to keep the patient with sickle cell disease:

  • Twice daily penicillin until age five to reduce serious infection
  • Talk to your doctor and, if appropriate, take hydroxyurea every day
  • Drinking plenty of water daily
  • Avoiding too hot or too cold temperatures
  • Avoiding over exertion and stress
  • Getting plenty of rest
  • Getting regular check-ups from knowledgeable health care providers

Patients and families should watch for the following conditions that need an urgent medical evaluation:

  • Fever
  • Chest pain
  • Shortness of Breath
  • Increasing tiredness
  • Abdominal swelling
  • Bad headache
  • Any sudden weakness or loss of feeling in an arm or leg or the face
  • Pain that will not go away with home treatment
  • Priapism (painful erection that will not settle)
  • Sudden vision change