Transcription
We have talked a lot about sickle cell disease, but now let's have a comparison between sickle cell anemia and sickle cell trait. It will be very straightforward. Okay.
Sickle cell anemia is hemoglobin SS in the genotype, which is a homozygous, while sickle cell trait is hemoglobin AS, which is a heterozygous. This is the carrier state because sickle cell disease is inherited in an autosomal recessive fashion. Okay.
Now you have hemoglobin, let's say it's 100 percent, but you have different types of hemoglobin. So in sickle cell anemia, you have 90 percent hemoglobin S, 8 percent hemoglobin F, 2 percent of hemoglobin A2, and virtually no hemoglobin A--no normal hemoglobin. Wow, that's something. Sickle cell trait, on the other hand, has 55 percent hemoglobin A, 43 percent hemoglobin S, and 2 percent of hemoglobin A2.
Pay attention: to sickle or not to sickle, this is the question. What are the causes of sickling? Number one was hemoglobin S concentration of more than 60 percent. So sickle cell anemia, of course, will sickle; sickle cell trait will not sickle under normal circumstances. It can only sickle under severe conditions such as hypertonicity and hypoxia in the renal medulla.
Symptoms in sickle cell anemia: we have hemolysis; we have vaso-occlusive crisis, which includes dactylitis, acute chest syndrome, and autosplenectomy, etc. In sickle cell trait, we have only hypostenuria, which is an inability to concentrate urine, as well as microscopic hematuria. Please note that in sickle cell trait, you can have renal papillary necrosis.
Okay, now on the lab, let's do a blood film or a peripheral smear and look at the cells. In sickle cell anemia, you will have sickle cells, target cells, as well as Howell-Jolly bodies. Howell-Jolly bodies are basophilic remnants in the red blood cells. Why is that? Because in sickle cell anemia, you have a functional asplenia; your spleen is useless, so you cannot remove these basophilic nuclear remnants. In sickle cell trait, there are no sickle cells for the most part, no target cells, and no Howell-Jolly bodies because the spleen is still functioning.
In sickle cell anemia, folic acid, antibiotics, and vaccinations are needed; maybe even transfusion or exchange transfusion in severe cases. Here, do nothing because sickle cell trait is completely benign.
That's it for the comparison. If you know anymore differences between sickle cell anemia and sickle cell trait, please let me know in the comment section below. Thank you very much for watching, and see you next time. Be safe. Study hard.