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Published on: June 22, 2012
Hypertension in sickle cell disease
C Narasimhan1, T George, J T George
1Department of Medicine Unit-I, CMC Hospital, Vellore, Tamil Nadu.
Summary
High altitude travel can trigger severe hypertension and splenic infarction in individuals with sickle cell trait. This condition, potentially caused by red blood cell sludging, may activate the renin-angiotensin system.
Area of Science:
- Nephrology
- Hematology
- Altitude Medicine
Background:
- Sickle cell trait is a common inherited blood disorder.
- High altitude environments present physiological challenges.
- Understanding trait-related risks at altitude is crucial.
Observation:
- A young male with sickle cell trait experienced severe hypertension and splenic infarction post-high altitude travel.
- Hypertension resolved after a diagnostic laparotomy but recurred.
- Blood pressure normalized spontaneously over 1.5 years.
Findings:
- Red blood cell sludging in renal microvasculature is a potential mechanism.
- Activation of the renin-angiotensin system may contribute to hypertension.
- Sickle cell trait can unmask susceptibility to altitude-related complications.
Implications:
- This case highlights the importance of considering sickle cell trait in unexplained hypertension after altitude exposure.
- Further research into altitude-induced hematological changes is warranted.
- Clinical vigilance is necessary for individuals with sickle cell trait traveling to high altitudes.
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