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Updated: Dec 12, 2025
A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
[Sickle cell trait complications: A case series of 6 patients]
C Marcombes1, E Lafont2, V Jullien1
1Département de médecine interne, Centre de référence des syndromes drépanocytaires majeurs de l'adulte, Hôpital européen Georges Pompidou (AP-HP), 20 rue Leblanc, 75015 Paris, France.
Insights
Sickle cell trait (SCT) can cause serious ischemic complications like splenic infarct and papillary necrosis, especially during hypoxia or dehydration. Consider hemoglobin testing in at-risk individuals with compatible ethnic origins.
Area of Science:
- Hematology
- Internal Medicine
- Genetics
Background:
- Sickle cell trait (SCT) is often viewed as asymptomatic.
- However, clinical manifestations can occur in individuals with SCT.
Observation:
- A retrospective study identified six SCT patients (aged 19-65) experiencing complications.
- Complications included splenic infarct (often after hypoxia/dehydration), papillary necrosis, and splenic sequestration.
- Most patients had elevated C-reactive protein levels.
Findings:
- SCT can lead to acute ischemic events, particularly splenic infarct and renal papillary necrosis.
- These complications are frequently associated with hypoxic or dehydrating conditions.
- Diagnosis of SCT was unknown in 2 out of 6 patients prior to their complication.
Implications:
- SCT patients may experience severe ischemic complications under specific environmental stressors.
- Hemoglobin evaluation is recommended for patients presenting with these complications and relevant ethnic backgrounds.
- This highlights the importance of recognizing SCT as a potential risk factor for certain medical emergencies.
Introduction:
Patients with sickle cell trait (SCT) are commonly considered as asymptomatic carriers. However, some clinical manifestations may occur.
Methods:
Here we present a retrospective descriptive study about SCT subjects with at least one complication diagnosed in a sickle cell disease referral center, in Paris, between 2008 and 2019. We also performed a literature review on the complications of SCT subjects.
Results:
Six patients (between 19 and 65 years old) were included. SCT was already known only for 4 of them at the time of the complication. Four patients presented with a splenic infarct after a stay in high altitude or a plane trip, one of them was associated with papillary necrosis; one patient had isolated papillary necrosis, and the last one had splenic sequestration. These complications happened for most of them after exposure to an unusual situation of hypoxia or deshydratation. Five out of 6 patients had a marked elevated C reactive protein.
Conclusion:
SCT may cause acute ischemic complications in a context of prolonged hypoxia or dehydration. The most commonly reported are the splenic infarct and the renal papillary necrosis. A study of hemoglobin should be considered in these clinical situations in patients with compatible ethnic origin.
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