Sickle Cell Disease and Blood Transfusion: What to Know
Since there is no means to acclimate to this risk we advise against high altitude exposure and sustained exercise at an altitude greater than 7,000 feet, but there is contrary evidence in the literature. Many individuals with sickle cell trait have participated at professional and international levels of sport, including reports from the Olympic competition in Mexico City and high altitude long distance running in the Cameroon. Theoretically consistent maintenance of conditioning and consistent adjustments to minimize EHI permit continued safe levels of participation. Heller et al. examined hospital admissions over three years for 4,900 veterans with Hb AS with a median age of 49 years and no time for follow-up .
That means it’s inherited or passed down from a parent to a child . Sickle cell trait is different from sickle cell disease , and in fact isn’t considered to be a disease. People with SCD have “sickle” shaped red blood cells due to an abnormal version of a protein called hemoglobin. During strenuous exercise, the abnormal hemoglobin in red blood cells can change the shape of those cells from round to a crescent moon or “sickle” shape. These sickled cells can build up in the blood vessels causing a blockage.
Performance levels should be built up gradually, avoiding severe muscle pain. Training should cease and restart gradually when substantial myalgia occurs. Adequate hydration with increased water intake rising with environmental heat stress is essential. In the evening of any hot day with a WBGT value above 75ûF, the athlete should be sure to ingest adequate amounts of salt and potassium to replace sweat losses and water to replace fluid deficits.
The remaining cells can easily become stuck in blood vessels or cause painful disruptions to blood flow. Blood pressure will be measured at the time of donation and must not be below requirements. You can donate as long as you feel well when you come to donate, and your blood pressure is at least 90 systolic and at least 50 diastolic at the time of donation.
I don’t have sickle cell anemia, but I carry the trait. Can I still give blood?
People who have one gene with the mutation and one normal gene have sickle cell trait and do not have the disease. People who have the mutation on both copies of the gene have sickle cell disease. Sickle cell trait and sickle cell disease have similarities and differences. The main difference is that sickle cell disease causes symptoms and has a major impact on an affected person’s health, but sickle cell trait does not. This article will discuss sickle cell trait, its relation to sickle cell disease, and how sickle cell disease is inherited. It will also explore how you might be diagnosed as having sickle cell trait and what effects this may have on your health.
Subsequently many cases of splenic infarction were reported from Lake Tahoe and other resorts in the Rocky Mountains. The possibility that white individuals with sickle cell trait are at greater risk of splenic infarction was suggested because of their predominance among cases occurring on the ground . Among 32 patients with sickle cell trait whose splenic infarction occurred while on the ground, at least 24 had white ancestry (75%). Since roughly four percent of Americans with sickle cell trait are non-black, one would expect only one non-black patient.
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Clinical features and distribution of cases between EHI and ISD did not differ by the presence or absence of hemoglobin S, except that rhabdomyolysis was the predominant form of EHI among cases with sickle cell trait . While fatal intravascular sickling with extensive microvascular obstruction could theoretical result from sickle cell trait, such an event cannot be demonstrated by histologic examination at autopsy. If a clinical event is not specific for hemoglobin S, one may need to show that the complication occurs significantly more often in people with sickle cell trait relative to a control group. Stronger evidence that polymerization of hemoglobin S causes a problem is demonstration of relative protection by alpha thalassemia. Sickle cell trait is inherited and means that an individual with the trait received a sickle cell gene from one parent but does not have sickle cell disease. Many individuals are unaware if they carry this trait as sickle cell trait testing at birth was not widely provided until 2006.
How do I make a blood donation?
Individuals with sickle cell disease can require frequent blood transfusions throughout their lifetime to treat complications of their disease. Unfortunately, this can make finding compatible blood types more difficult when patients develop an immune response against blood from donors that is not closely matched to the blood of the recipient. The American Red Cross has launched a new national initiative to reach more blood donors who are Black to help patients with sickle cell disease and improve health outcomes. In the U.S., it is estimated that over 100,000 people have sickle cell disease and may require regular blood transfusions throughout their lifetime.
Bleeding is unilateral for 90% of cases, with the left kidney the dominant site. Bleeding can be stopped by applying local pressure, by cauterizing small vessels which are bleeding, or by using chemicals thought to promote coagulation of injured surfaces. Evaluation of hematuria routinely includes an IVP, ultrasound, and CT scan. The IVP will often show lesions at the tip of multiple calcynes in both kidneys. The most sensitive tests are a retrograde IVP and urteroscopy, which are reserved for patients with problems requiring intervention to reduce bleeding. Over-hydration is possible with consequent hyponatremia, seizures, and death.
Below, you will find a list of questions donors frequently ask. The eligibility criteria for donation at the National Institutes of Health Department of Transfusion Medicine reflects local NIH policy as well as national regulations. Although all blood banks are required to follow general federal regulations, specific criteria may vary, depending on each blood bank’s internal policies. If you are donating at a blood bank other than the NIH Blood Bank, contact that bank with any questions regarding your eligibility. Many who carry the trait will have no medical conditions related to sickle cell disease.
How do I know if I have sickle cell trait? What is sickle cell trait screening?
These medicines lower the chance of your immune system rejecting the donor blood, protecting you from a life-threatening transfusion reaction. If you have sickle cell disease , you may need one or more blood transfusions during your lifetime. During a blood transfusion, your blood and the donated blood must have matching antigens, or special proteins on the surface of each red blood cell. In the United States, an estimated 100,000 people of various racial and ethnic backgrounds have sickle cell disease, with the majority being of African descent.
See Figure 1B in the article by Faes et al that begins on page 2529. Additionally, a person who is at risk of having CJD or has a blood relative with the condition was previously not able to donate blood. However, the FDA now suggest that those who were previously not eligible to donate blood for this reason are now able to reapply.
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Donate Blood for Sickle Cell
DayShana Jones, sickle cell patient, describing the importance of blood donations. Sickle cell disease occurs when a person inherits two abnormal genes that code for hemoglobin , which leads to the red blood cell sickling reaction. A defect in the beta globin gene causes sickle cell disease.
Unfortunately, frequent transfusions can make finding compatible blood types even more difficult if patients develop an immune response against blood from donors that is not closely matched to the blood of the recipient. Normal red blood cells are disc-shaped and move with ease throughout the body. But patients with sickle cell disease have stiff, sticky red blood cells shaped like crescents that do not easily flow to vital limbs and organs.
The best dose and duration for use of EACA in treatment of hematuria related to sickle cell trait has not been adequately investigated. The best documented effective dose schedule is 3 grams three times to four times per day for a period of one week, expecting to stop hematuria in two to three days for most patients. Whether given orally or intravenously seems to make little difference. The optimal treatment duration after macroscopic hematuria has stopped remains unknown with a range of clinical experience from three days to six weeks. Our recommendation is to continue with 9 to 12 grams of EACA daily for one to two weeks after cessation of hematuria using the longer period for patients who seem at high risk for recurrence. With more experience treating sickle cell disease all of these measures have been pursued less completely.
Giving blood is a small action that makes a huge impact, especially for people living with sickle cell disease. Donating blood takes one hour, and you could save someone’s life. Tips for team doctors to prevent exercise-related illness and keep their athletes with sickle cell trait safe and healthy while engaging in physical activity.
We examined the effect of age on risk of ERD unexplained by preexisting disease. There was an eight-fold increase in mortality going from age to age among recruits with Hb AS but no such trend for recruits without sickle cell trait . This difference in effect of age suggests that there may be a difference in pathogenesis of death depending on the presence or absence of hemoglobin S. This effect might be due to renal papillary necrosis from Hb AS, a lesion increasing linearly in severity with age and present in at least 80% of recruits . The resulting deficit in renal concentrating ability might predispose that person toward more severe EHI since obligatory loss of free water might increase the hyperosmolar state important in the pathogenesis of EHI.
This allows your body to transport vital gases and nutrients. Variant Creutzfeldt-Jakob disease is a very rare, fatal disease that can infect a person for many years before making them sick by destroying brain cells. Eating beef and beef products contaminated with the infectious agent of bovine spongiform encephalopathy is the main cause of vCJD.
When the other copy of the gene is normal, the red blood cells will have normal hemoglobin proteins, so symptoms and effects of sickle cell disease will not develop. Stroke.This is another sudden and severe complication of people with sickle cell disease. The misshapen cells can block the major blood vessels that supply the brain with oxygen. Any interruption in the flow of blood and oxygen to the brain can result in severe brain damage. If you have one stroke from sickle cell anemia, you are more likely to have a second and third stroke. Sickle beta thalassemia disease is a type of sickle cell disease.
It is important to note that carrying the sickle cell trait does not mean that an individual has sickle cell disease. In general, individuals who carry the sickle cell trait have no medical conditions related to sickle cell disease. Your children can also have a risk of inheriting sickle cell disease if their other genetic parent has sickle cell trait or sickle cell disease. Sickle cell trait is a condition of having one sickle cell gene mutation. You may have a small risk of surgical complications or a risk of serious complications from athletics if you have sickle cell trait.
Gross hematuria producing anemia and requiring blood transfusions has an unpredictable course. The problem can persist for weeks to months with many recurrent episodes. Occasionally bleeding becomes so profuse that anemia is life-threatening. Episodes of severe bleeding are more common in men than in women. Most are unilateral with the left kidney involved more frequently than the right, while 10% are bilateral. Spontaneous resolution without any treatment occurs frequently, making the evaluation of any form of treatment difficult in the absence of controls.
However, our survey of 41 recruit ERDs, demonstrated that non-sudden exertional heat illness deaths and idiopathic sudden death each accounted for about one-third of ERD . It seemed possible that EHI contributed to a much larger fraction of recruit deaths than was found in most of the autopsy studies of ERD of civilian athletes. If the tattoo artist and establishment are in a state that regulates tattoo facilities, there is no waiting time to donate blood. If not, a person will have to wait 3 months before donating blood. AB plasma is a universal donor plasma because it is compatible with all blood types. Plasma donors can undergo apheresis to take out the plasma from whole blood.
In 1981 we embarked on studies of exercise-related death among US military enlisted recruits in basic training which took advantage of the potential for accurate epidemiologic analysis. Large exercising populations of apparently healthy young adult recruits were enumerated with an accuracy greater than 96% in a database describing each individual. Because of medical, legal, and military command concerns, each recruit death has been investigated in detail, with a full autopsy and toxicology, clinical records, and eyewitness accounts.
The physician should consider the possibility of an inherited metabolic disorder contributing to unexpected elevation of serum muscle enzymes. The level of heat stress is affected by the extent to which clothing permits heat loss and blocks radiant sunlight. High metabolic activity should be conducted in loose, light clothing during hot weather, with appropriate protection from radiant sunlight, such as head cover, during lesser activity. Rapid treatment in the field and during transport to a hospital is the best was to minimize the severity of exertional heat illness. Demanding physical conditioning is safer when conducted with an experienced trainer or medical personnel.
Type O-negative blood can be transfused to patients of all blood types. Talk with a doctor about the risks and benefits of a blood transfusion to manage your SCD, and be sure to tell a doctor about any allergies you have or prior reactions to blood transfusions. When the blood transfusion is complete, the medical team will still monitor you for a time. They’ll likely remove your IV line if you received blood as an outpatient procedure.
This is why it is important to understand how beta thalassemia trait is passed on, and how it can affect the health of your children and grandchildren. An important controlled study of EACA was conducted a decade later . The duration of hematuria was examined for patients with hemoglobin S.
These measures have been justified by theoretical considerations rather than substantial controlled observations . While this appearance can be mimicked by a number of other processes, such a pattern of necrosis with acute onset is unlikely when the precipitating disorder is not obvious . One exception is traumatic hemorrhage, which can progress over months or years, causing slow enlargement of the spleen and even erosion of adjacent ribs. Splenic infarction is readily differentiated from the early lesions of DIC, which are tiny foci of hemorrhagic necrosis diffusely scattered throughout the spleen. Prolonged DIC may produce large areas of hemorrhage, mimicking infarction from sickle erythrocytes. Liver-spleen scan with sulfur colloid usually demonstrates decreased perfusion of large regions of the spleen but are not as sensitive as the CT scan.
Splenic infarction usually presents as severe abdominal pain localizing within a few hours to the left upper quadrant, accompanied by nausea and vomiting. Splinting of the left hemithorax, left pleural effusion, and atelectasis of the left lung often follow. Fever, leukocytosis, and an acute elevation of serum LDH level occur during the first 72 hours, out of proportion to serum CK, AST, or ALT levels.