Sickle-cell disease laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2] Shyam Patel [3]

Overview

The most important laboratory test for sickle cell anemia is a complete blood count (CBC), specifically hemoglobin and hematocrit.

Laboratory findings

Blood tests

Full blood count will reveal haemoglobin levels in the range of 6-8 g/dL with a high reticulocyte count. On a peripheral blood film, one can observe features of hyposplenism i.e., target cells and Howell-Jolie Bodies. Sickling of the red blood cells, on a blood film, can be induced by the addition of sodium metabisulphite. Another test is Sickle Solubility test. A mixture of haemoglobin S (Hb S) in a reducing solution e.g., sodium dithionite gives a turbid appearance while normal Hb gives a clear solution. Abnormal hemoglobin forms can be detected on hemoglobin electrophoresis, a form of gel electrophoresis on which the various types of hemoglobin move at varying speed. Sickle-cell hemoglobin (HgbS) and hemoglobin C with sickling (HgbSC)—the two most common forms—can be identified from there. Genetic testing is rarely performed.