Morbidity associated with sickle cell trait carriers

Moussa Seck, Yannick Soubaiga, Blaise Félix Faye, Diariétou Sy, Sokhna Aissatou Touré, Nata Dieng, Abibatou Sall, Awa Oumar Touré, Saliou Diop


Background: Sickle cell trait carriers has long considered asymptomatic. This affirmation is now challenged because many patients complain of osteoarticular pain and several organic degenerative complications in particular; renal, eye and sudden death have been described. The objective of this study was to evaluate the morbidity of sickle cell trait and identify risk factors associated.

Methods: This is a prospective study with duration of 16 months including 50 patients with sickle cell trait received regular visits (every 6 months) for painful events. Biological assessment was carried out systematically to eliminate rheumatic disease (CRP, ASLO, latex Waler Rose) or metabolic disorders (serum calcium, serum magnesium, and serum uric acid). A correlation between clinical and laboratory data was performed to study the relationship between morbidity observed and biological abnormalities.

Results: Mean age of patients was 32 years (12-59) and mean age at diagnosis was 24 years (12-55 years). Sex ratio M/F was 0.16. Clinical symptoms were osteoarticular pain (88%), headache (86%), abdominal pain (76%), muscle cramps (70%), dizziness (56%), biliary lithiasis (6%), femoral head osteonecrosis (2%) and gross haematuria (2%). Seventeen patients (34%) had abnormal metabolic or rheumatic analysis. No risk factor associated with morbidity of patients was identified.

Conclusions: This work has allowed us to find that the symptoms presented by sickle cell trait patients are dominated by painful events. This morbidity associated with porting sickle cell trait was not secondary to inflammatory or metabolic disorders or physical activity.


Abdominal pain, Headache, Muscle cramps, Osteoarticular pain, Sickle cell trait

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Gibson JS, Rees DC. How benign is sickle cell trait? EBioMedicine. 2016;11:21-2.

Burnham-Marusich AR, Ezeanolue CO, Obiefune MC, Yang W, Osuji A, Ogidi AG, et al. Prevalence of Sickle Cell Trait and Reliability of Self-Reported Status among Expectant Parents in Nigeria: Implications for Targeted Newborn Screening. Public Health Gen. 2016;19(5):298-30.

Mbodji M, Ndoye O, Diarra M, Mbaye BN, Sow Touré H, Diouf L et al. Sickle cell disease neonatal screening first evaluation. Dak Med. 2003;48(3):202-5.

Lionnet F, Arlet JB, Bartolucci P, Habibi A, Ribeil JA, Stankovic K. Recommandations pratiques de prise en charge de la drépanocytose de l'adulte. Rev Med Int. 2009;30:162-223.

Duvic C, Bordier L, Hertig A, Ridel C, Didelot F, Herody M, et al. Macroscopic hematuria associated with sickle cell anemia trait: report of ten cases. Rev Med Int. 2002;23(8):690-5.

Verschuren F, Thys F, Kong Kam Wa I. An unusual etiology of macroscopic haematuria in the emergency room: renal papillary necrosis in the heterozygous sickle cell patient. SET. 2008;21:70-3.

Leveziel N, Lalloum F, Bastuji-Garin S, Binaghi M, Bachir D, Galacteros F et al. Sickle cell retinopathy: retrospective analysis of 730 patients followed in a reference center. J Fr Ophtalmol. 2012;35(5):343-7.

Loosemore M, Walsh SB, Morris E, Stewart G, Porter JB, Montgomery H. Sudden exertionnal death in Sickle cell. Br J Sports Med. 2012;46(5):312-4.

Diaw M, Samb A, Diop S, Diop N, Ba A, Cissé F et al. Effects of hydration and water deprivation on blood viscosity during a soccer game in sickle cell trait carriers. Br J Sports Med. 2014;48(4):326-31.

Mitchell. Sickle cell trait and sudden death-bringing it home. J Natl Med Assoc. 2007;99(3):300-5.

Diaw M, Diop S, Soubaiga FY, Seck M, Faye BF, Niang MN et al. Blood viscosity is lower in trained than in sedentary sickle cell trait carriers. Clin Hemorheol Microcirc. 2015;61(1):23-9.

Jonathan CG, Vence LB, Clinton HJ, Gregory JK, Allan SN, Martin HS. Framing the research agenda for sickle cell trait: building on the current understanding of clinical events and their potential implications. Am J Hematol. 2012;87(3):340-6.

Diop S, Mokomo SO, Ndiaye M, Touré Fall AO, Thiam D, Diakhaté L. Homozygous sickle cell disease after the age of 20: followed by a cohort of 108 patients at the Dakar University Hospital. Rev Med Int. 2003;24(11):711-5.

Diop S, Diop D, Seck M, Gueye Y, Faye A, Diéye TN et al. Predictors of chronic complications of homozygous sickle cell anemia in adults in Dakar (Senegal). Med Trop. 2010;70:471-4.

Kiryluk K, Jadoon A, Gupta M, Radhakrishnan J. Sickle cell trait and gross hematuria. Kidney Int. 2007;71(7):706-10.

Nigel SK, Vimal KD. Sickle- cell trait: Novel Clinical Significance. Hematology Am Soc hematol Educ Program. 2010;12:418-22.

Reynolds SA, Besada E, Winter-Corella C. Retinopathy in patients with sickle cell trait. Optometry. 2007;78(11):582-7.

Jean-Baptiste G, De Ceulaer K. Actuality of rheumatological manifestations of hemo-globinopathies. Rev Rhum. 2003;70:157-61.

Desmurs-Clavel H. Persistent anemia in a patient with MG and heterozygous sickle cell disease. Press Med. 2009;38:2553-5.

Habibi A, Bachir D, Godeau B. Les complications aigues de la drépanocytose. Rev Prat. 2004;54(8):1548-56.

Tsaras G, Owusu-Ansah A, Boateng FO, Amoateng-Adjepong Y. Complications associated with sickle cell trait: a brief narrative review. Am J Med. 2009;122(6):507-12.

Connes P, Hue O, Hardy-Dessources MD, Boucher JH. Hemorheology and heart rate variability: is there a relationship? Clin Hemorheol Microcirc. 2008;38:257-65.