Action if sickle test ve

• Delay elective operation until established whether disease or trait.

• Ask about family history of sickle cell anaemia or symptoms of SCA.

FBC and film features of sickle trait vs. disease

Sickle cell trait FBC— normal or 5 MCV & MCH, no anaemia

Film normal (may be microcytosis or target cells)

Sickle cell disease FBC—Hb~7-8g/dL (range ~4-11g/dL)

Film—sickled RBCs, target cells, polychromasia, basophilic stippling, NRBC (hyposplenic features in adults)

• Hb electrophoresis.

• Group and antibody screen serum.

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