Sickle cell anaemia: pathogenesis, triggers, clinical features and treatment ...

in #hive-1963876 months ago

Good day, my beautiful people,
I know you have been hearing of this pathological condition, sickle cell anaemia which we abridge as SS in this part of the country but do you actually know what it's all about?

In this post, I'll be walking you through exactly what it's all about and I do hope you learn something new....

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What is Sickle Cell Anaemia

This is the pathological condition where someone inherits the S haemoglobin in homozygous state, that is the person has two S haemoglobin (SS), one from each parent.

What is the Difference?

In other haemoglobin structures like AA, AS, glutamic acid is present on the position 6 of the beta-haemoglobin chain but for sicklers, valine replaces this.
Someone might think this isn't a big deal but well, that's the main issue with the whole to-and- fro sicklers go to the hospital for.

Do you know how?

This valine is a fat soluble amino acid unlike glutamic acid which is a water soluble amino acid, under low oxygen (hypoxia), it makes the red blood cells of sicklers to clump together forming tactoids leading to blockage of blood vessels causing severe pain.
Even as the red blood cells are clumped, they still try as much as possible to pass through these blood vessels and this rigidity causes these red blood cells to break easily (fragility) thereby reducing their lifespan.

Triggers

Under good oxygen saturation, sicklers have no problem at all but there are some conditions at which causes these red blood cells to sickle....

  • Low oxygen concentration
  • Infections
  • Malaria
  • High white blood cells
  • Fever
  • Dehydration
Clinical Features

These are some symptoms that you will see in a child and you will suspect that the blood group might be SS prompting you to check the blood group....

Dactylitis:

This is also known as hand-foot- syndrome and happens by swelling of the hands and feet of the child. This usually happens at 6months although it isn't a must that every sickler must suffer this just that it's a great pointer to it.

Hepatomegaly:

This simply means enlargement of the liver. Just like you've seen above that sicklers' blood clump up to form tactoids and block blood vessels, sometimes, these blockage occur within the liver causing them to enlarge.

Splenomegaly:

This simply means enlargement of the spleen.
The spleen is charged with destruction of worn out and malformed red blood cells; sicklers' red blood cells are deformed in morphology by the sickled shape they have, hence, whenever they reach the spleen, it breaks them down amd because of the excessive breakdowns occuring in sickle cell crisis, they get bigger... What is called hypertrophy.

Jaundice:

This is the yellowish discoloration of the skin and sclera and happens as a result of excess bilirubin in the body.
Bilirubin is one of the by-products of haemoglobin and as a result of the excessive breakdowns, the bilirubin level in the blood gets too much that the body is overwhelmed to excrete all of them and as such, it starts depositing in the skin and sclera causing jaundice.

Treatment

The truth is that there is no definitive treatment for this pathologically condition however there are various ways by which it could be managed to atleast help the patient live a better life avoiding the whole constant hospital visitation....

  • Adequate Hydration:

By adequate hydration, I simply means taking enough water; when sicklers take enough water, it helps prevent dehydration which is one of the major risk factors that causes them crisis because it favours blood clumping.

  • Malaria prophylaxis:

Regular taking of malaria prophylaxis helps to reduce the crisis sicklers have and also the severity.

  • Avoiding High Altitude:

The higher you climb mountains, the less oxygenated the air you breath in becomes and low oxygen (hypoxia) is one of the major triggers of crisis.

  • Folic acid supplementation:

Because of the recurrent haemolysis (red blood cells breakdown) sicklers suffer, the body keeps on producing more and more to match up with the breakdowns and folate stores keep depleting, as a result of that, sicklers are given folic acids to help build up their folate stores.

  • Health education and Counselling:

This is the most important factor.
It's always painful when I see sicklers in the clinic because I know that this could have been easily prevented just with enlightenment.
Please, before we start "our love is blind motto", please let's all endeavour to check our blood groups and ensure they are compatible to save this little ones from the pain that comes with these sickle cell crisis.


I hope you learnt something new or I remembered you what you already knew...

Thanks for reading and have a great day ahead

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could have been easily prevented just with enlightenment.

That's the sad part, the whole trouble that comes with this condition could have been very easily prevented.

You dissected the matter with detail. 👍

Thanks Doc for your delightful comment... I appreciate

We've got work to do with the enlightenment

Serious work bro, and we will.

Sure

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👏 Keep Up the good work on Hive ♦️ 👏
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Thank you a lot

@sperosamuel15, you are most welcome!

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Thanks

Thanks ... I already delegated, I'll still delegate more when I get more

I feel like Val has crept into my reading a lot lately.

Do you think that maybe something like CRISPR could be used to modify the sequence for future erythrocyte production via hematopoietic stem cells? I wonder what the underlying sequence looks like and if it is heavily replicated in the genome.

I recently saw this new technological advancement and read about it... It really looks promising.
I really don't know if it can because we haven't even used it here for the first time so I haven't had a first-hand experience but it looks quite promising.

I'm not sure it's been used in humans in general. The problem would be reside in repeat sequences. You have to cut the nucleotides of interest out and then it gets "repaired" with the dna you're trying to insert.

Yes, I think I read about that too...
Well, we just have to wait for it's first human use and then look out for the possible complications it might have... Once the benefits exceeds the disadvantages, I think we're good to go

I think we're quite a ways away from that. Many problems from sickle cell are secondary to the morphology of the cell right? I'd say it'd be really hard to fix this condition without genetic modification.

Absolutely correct.... All their problems are from the defective or rather point mutation on the chromosome