Splenic infarction in a white man with sickle cell trait

Area of Science:

• Hematology
• Cardiovascular Physiology
• Altitude Medicine

Background:

• Sickle cell trait (SCT) is generally considered benign.
• Splenic infarction is a known, albeit rare, complication of SCT.
• High altitude exposure can precipitate sickling events in individuals with hemoglobinopathies.

Observation:

• A young white male with SCT experienced splenic infarction during high-altitude travel (10,800 feet).
• The patient had a high hemoglobin S concentration (40%).
• The event occurred despite the absence of strenuous physical activity.

Findings:

• Hypoxemia at high altitude, combined with a significant hemoglobin S level, appears to be a critical factor.
• These conditions likely interacted with splenic blood flow dynamics to induce sickling and subsequent infarction.
• This represents the third reported case of splenic infarction associated with sickle cell trait.

Implications:

• The optimal management strategy for this rare SCT complication requires further investigation.
• Surgical intervention may not be necessary for diagnosis or treatment of splenic infarction in SCT.
• Highlights the potential risks of high-altitude exposure for individuals with sickle cell trait, even in the absence of typical triggers.