blood Sickle Cell Disease Articles

How I treat renal complications in sickle cell disease
Claire C. Sharpe , Swee Lay Thein
Jun 12, 2014
Heme-induced neutrophil extracellular traps contribute to the pathogenesis of sickle cell disease
Grace Chen , Dachuan Zhang , Tobias A. Fuchs , Deepa Manwani , Denisa D. Wagner , Paul S. Frenette
Jun 12, 2014
Evidence-based focused review of the status of hematopoietic stem cell transplantation as treatment of sickle cell disease and thalassemia
Allison King , Shalini Shenoy
May 15, 2014
Microvascular oxygen consumption during sickle cell pain crisis
Carol A. Rowley , Allison K. Ikeda , Miles Seidel , Tiffany C. Anaebere , Matthew D. Antalek , Catherine Seamon , Anna K. Conrey , Laurel Mendelsohn , James Nichols , Alexander M. Gorbach , Gregory J. Kato , Hans Ackerman
May 15, 2014
Platelet bioenergetic screen in sickle cell patients reveals mitochondrial complex V inhibition, which contributes to platelet activation
Nayra Cardenes , Catherine Corey , Lisa Geary , Shilpa Jain , Sergey Zharikov , Suchitra Barge , Enrico M. Novelli , Sruti Shiva
May 01, 2014
How we treat sickle hepatopathy and liver transplantation in adults
Kate Gardner , Abid Suddle , Pauline Kane , John O’Grady , Nigel Heaton , Adrian Bomford , Swee Lay Thein
Apr 10, 2014
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ASH ® Image Bank

Pappenheimer Bodies in Sickle Cell Disease

A 26-year-old AF male with sickle cell disease who presented to the ER complaining of abdominal pain. His CBC at that time showed a hemoglobin of 7.2g/dL, WBC of 11.2k/uL and a platelet count of 360k/uL. His peripheral smear is show. Sickle cells are readily identified (intermediate-sized arrow) throughout the smear. A RBC with a Howell-Jolly body (small arrow) is also noted. Multiple irregular inclusions (large arrow) are present in many of the other RBC. These iron-containing granules are Pappenheimer bodies. A Prussian Blue is needed to confirm the presence of non-heme iron in these granules. Also note on this smear increased polychromatophilic cells and target cells.

Fish mouth vertebrae and sickle cell spine

A 22-year-old male with sickle cell disease (SCD) presented to the emergency department with a chief complaint of acute left lower extremity pain and a non-productive cough. PA and lateral chest roentograms were obtained revealing biconcave vertebral defects or "fish mouth" vertebrae. Developing in greater than seventy percent of patients with SCD, the depicted vertebral changes result from infarction of the vertebral bodies and thinned trabeculae allowing hyperplastic marrow to expand into the central vertebral space (solid arrows, Panels A and B). Debate exists regarding appropriate terminology as "fish" or "fish mouth" vertebrae. Though the appearance of the intervertebral disks resembles a fish mouth, the biconcave vertebral bodies are strikingly similar to a salmon’s vertebrae (dashed arrow, Panel C*).

Aplastic Crisis in a Patient with Sickle Cell Disease

Numerous sickled RBC's are present (small arrows). A single nucleated RBC is noted (large arrow). Of note is the absence of polychromasia.

Sickle cell disease – RBC morphology

Peripheral smear from a patient with sickle cell disease illustrates the spectrum of RBC findings in this disorder including sickle cells, polychromatophilic RBCs, target cells, and Howell-Jolly bodies.

Sickle cell disease – RBC morphology - 2

In addition to the RBC findings noted in Fig. 1, this image shows a nucleated RBC (arrow).

Sickle cell disease – RBC morphology - 4

Crescent-shaped sickle cells are noted (double arrow). Several RBCs with Howell-Jolly bodies are also present. One has two such inclusions (single arrow).

Pappenheimer bodies and basophilic stippling in sickle cell disease

The Pappenheimer bodies are shown at high magnification. The inclusion in the RBC at the top center of the image has the appearance of a Howell-Jolly body.

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blood How I Treat

How I treat renal complications in sickle cell disease
Claire C. Sharpe , Swee Lay Thein
Jun 12, 2014
How we treat sickle hepatopathy and liver transplantation in adults
Kate Gardner , Abid Suddle , Pauline Kane , John O’Grady , Nigel Heaton , Adrian Bomford , Swee Lay Thein
Apr 10, 2014
View More Articles »

My Say

Sickle cell disease has come full circle

Swee Lay Thein, MB, BS, FRCP, FRCPath, DSc, FMedSci
Professor of Molecular Haematology / Consultant Haematologist
King's College London School of Medicine / King's College Hospital
London, UK

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Feature Editor: Dr. Swee Lay Thein