Understanding Sickle Cell Trait and Disease
Sickle Cell Trait
People with inherit two genes for sickle hemoglobin — one from each parent.
People with sickle cell trait inherit one sickle hemoglobin gene from one parent and one normal gene from the other parent.
Who Has Sickle Cell Trait?
According to the American Society of Hematology, between 1 million and 3 million Americans have sickle cell trait, and more than 100 million people have it worldwide.
Like sickle cell anemia, sickle cell trait is most common among people of African, Middle Eastern, Mediterranean, Central and South American, and Asian Indian origin or descent.
Having sickle cell trait has been found to offer some survival advantage against malaria.
Not surprisingly, sickle cell trait is most prevalent in areas of the world affected by malaria.
In the United States sickle cell trait is most common among African-Americans: About one in 12 African-Americans has it. Among Hispanic Americans, one in 100 has it.
While most people with sickle cell trait can safely participate in sports and exercise, some athletes with the trait have experienced illness or have even died as a consequence of strenuous exertion.
Exercising too intensively can lead to exertional rhabdomyolysis, a condition in which skeletal muscle rapidly breaks down.
Signs and symptoms of exertional rhabdomyolysis include fatigue, muscle pain, and darkened urine.
In response to a lawsuit following the death of a college football player with undiagnosed sickle cell trait in 2006, the National Collegiate Athletic Association (NCAA) now requires all athletes at Division I and II schools to be tested for sickle cell trait — or to sign a written release declining testing — before competing.
Preventive measures to avoid overexertion and problems associated with exercising in hot or humid conditions include:
- Drinking adequate fluids during games and workouts
- Following a progressive workout plan that builds up gradually
- Taking rest breaks during games and workouts
- Training coaches and other athletic staff to recognize when a participant is in physical distress.
If any athlete with sickle cell trait begins to struggle in a drill, the drill should be stopped and medical attention should be promptly provided.
Other Complications of Sickle Cell Trait
Although sickle cell trait is generally considered a benign, or harmless, condition, it has been associated with a variety of medical conditions, including:
- Blood in the urine
- Chronic kidney disease
- Complications following the treatment of hyphema (blood in the anterior chamber of the eye following injury)
- Early onset of kidney failure in people with autosomal dominant polycystic kidney disease
- More frequent urinary tract infections in women
- Renal medullary carcinoma, a very rare and highly aggressive form of kidney cancer that occurs almost exclusively in adolescents and young adults
- Splenic infarction (cutting off of the blood supply to the spleen), particularly at high elevations or when traveling in unpressurized airplanes
People with sickle cell trait can pass the sickle gene on to their children.
If both parents have sickle cell trait, there's a chance their children will have sickle cell anemia.
If one person in a family is diagnosed with sickle cell anemia, it's often advised that the whole family be tested so that each member knows his or her sickle cell status.
Video: Difference Between Sickle Cell Disease and Sickle Cell Anemia
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