Key messages

• Sickle cell trait is not a disease, but problems may develop under hypoxic conditions.

• The sickle cell gene is not confined to people of African origin.

• Sickle hemoglobin is an efficient carrier of oxygen, and transfusion of patients at their steady state hemoglobin level is not justified to increase oxygen carriage.

• Different genotypes of sickle cell disease manifest highly variable clinical courses.

• Most patients are well between complications, many of which have precipitating factors which can sometimes be avoided.

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