Davon is a 5-year-old African American male who has just moved to Chicago, and he is visiting his new pediatrician for a kindergarten physical. His mother tells the nurse that she carries the sickle cell trait and wants Davon screened for it. Davon may have the sickle cell trait.
The doctor will perform a blood test to see if the child has normal hemoglobin A and abnormal hemoglobin. The nurse will use a glass tube to extract blood from the child. The plasma proteins and platelets will start to from a clot. The test will find an abnormal hemoglobin S in the red blood cells if the child carries the sickle cell trait. It is common in sickle cell traits to have a little more hemoglobin A than hemoglobin S. Hemoglobin A aids in the red blood cells moving oxygen to the body. A sickle cell does not have the normal shape of a blood cell. It is because of the shape that it may clog small blood vessels resulting in lack of blood and oxygen to major organs. When the blood test comes back positive on the screening test the doctor will run a second test. A hemoglobin electrophoresis will confirm the diagnosis. An early diagnosis can determine the treatment, if needed, for the child. In certain states it is a required screening for newborns.
The cause is believed to be from ancestors who were around malaria. The sickle cell provides protection from contracting malaria. The trait is found in 1 in 12 African- Americans. If one parent has the trait it is a 50% chance it could be passed to the child. If both parents have the trait there is a 50% chance the child will inherit the trait and a 25% chance the child could inherit the disease. The sickle cell trait passed on to the child does not mean that the child will have sickle cell disease. It would be a very rare case if the person with the trait showed symptoms of the disease.
If the child has sickle cell disease treatment can range from surgery to medication, and even blood transfusions. There are three types of sickle cell disease. They are sickle cell anemia, sickle-hemoglobin C disease, and sickle beta thalassemia disease. Sickle cell anemia is the most common form of the disease. The only cure for the disease is a bone marrow transplant. There are many stipulations to the bone marrow transplant. There must be a donor to match the bone marrow. The need for a matched donor is to reduce rejection of the marrow. There is always a risk that the transplanted bone marrow will be rejected. If the child cannot find a match the child can still have a good life. The child will be placed on antibiotics. The most common antibiotic is penicillin. The penicillin has to be administered twice a day and immunizations must be up to date. The pneumococcal, influenza, and meningococcal vaccines are the most important vaccines. The pneumococcal and meningococcal vaccines help to prevent life threatening blood infections such as pneumonia or meningitis. Sometimes folic acid can be prescribed, as it helps to