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VIII.127 - Sickle-Cell Anemia

from Part VIII - Major Human Diseases Past and Present

Published online by Cambridge University Press:  28 March 2008

Kenneth F. Kiple
Affiliation:
Bowling Green State University, Ohio
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Summary

Sickle-cell disease is an inherited disorder resulting from an abnormality in the structure of a protein in the red blood cell called hemoglobin. It represents a spectrum of disorders ranging from the full-blown form, sickle-cell anemia, to the carrier state called sickle-cell trait. Also included in this spectrum are several other variant hemoglobin disorders, which all have the sickle hemoglobin. Sickle-cell anemia is the prototype for most molecular diseases and was the first disease to have its cause isolated to a single molecular change in the human genetic structure. This single change is responsible for all of the dramatic physiological changes and clinical events that occur in this disease.

Sickle-cell trait occurs when the individual is heterozygous for the sickle-cell gene and results in red blood cell concentrations of the abnormal hemoglobin (hemoglobin S) of less than 50 percent. It generally does not result in serious illness although this generalization has recently been disputed. In addition to sickle-cell trait, several sickle-cell syndromes occur when hemoglobin S is present in a heterozygous state with other hemoglobin variants – some with similar properties. Common examples of these include hemoglobin C and hemoglobin E.

Distribution and Incidence

Sickle-cell anemia is found in as many as 4 percent of Africans and in 1 percent of black Americans (1 per 500). Upward of 40 percent of Africans carry the sickle-cell trait as compared to 9 percent of black Americans. In some Mediterranean cultures the trait is also present. It is now generally believed that the sickle-cell gene mutation occurred independently in several areas of Africa.

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Publisher: Cambridge University Press
Print publication year: 1993

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References

Allison, A. C. 1954. Protection afforded by sickle-cell trait against subtertian malaria infection. British Medical Journal i.Google Scholar
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Glader, B. E. 1986. Screening for anemia and erythrocyte disorders in children. Pediatrics 78.Google ScholarPubMed
Herrick, J. B. 1910. Peculiar elongated and sickle-shaped red blood corpuscles in a case of severe anemia. Archives of Internal Medicine 25.Google Scholar
Kark, J. A., et al. 1987. Sickle cell trait as a risk factor for sudden death in physical training. New England Journal of Medicine 317.CrossRefGoogle ScholarPubMed
Motulsky, A. G. 1973. Frequency of sickling disorders in U.S. blacks. New England Journal of Medicine 288.CrossRefGoogle ScholarPubMed
Savitt, Todd L., and Goldberg, Morton F.. 1989. Herrick’s 1910 case report of sickle cell anemia: The rest of the story. Journal of the American Medical Association 261.Google ScholarPubMed
Scott, R. B. 1985. Advances in the treatment of sickle cell disease in children. American Journal of the Diseases of Childhood 139.Google ScholarPubMed
Sears, D. A. 1978. The morbidity of sickle cell trait: A review of the literature. American Journal of Medicine 64.CrossRefGoogle ScholarPubMed

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