Sickle Cell Trait
What does it mean to carry sickle cell (AS)?
Sickle cell is a haemoglobin disorder. Many people of “not Northern European origin” carry sickle cell trait (black Africans 25%, African Caribbeans 10%, people from S. Europe, Cyprus and the Middle East about 1%. Sickle cell is also occasionally found among Indians and Pakistanis). Less than 0.1% of Northern Europeans are carriers. The diagnosis of sickle cell and other abnormal haemoglobins is based on electrophoresis.
Haemoglobin disorders are recessively inherited. People who carry one gene for sickle cell (heterozygotes) are popularly called sickle cell carriers, said to be “AS” or said to have “Sickle Cell trait”.
“You carry sickle cell because you inherited it from one of your parents. Your children may inherit it from you in their turn. You will always carry it. No-one can "catch" it from you, and it will never turn into a “serious anaemia”.
Can sickle cell cause any health problems for carriers?
Sickle cell carriers are as healthy as other people. They are not ill, and are no more likely to become ill than other people. They do not need medical treatment.
Very rarely, a sickle cell carrier can have one of the following problems:
If a sickle cell carrier gets extremely short of oxygen, they may develop a painful "sickle cell crisis". If you ever go into hospital for an operation, you should tell the medical staff that you carry sickle cell. They need to know, so that they can make sure you do not get short of oxygen if you have an anaesthetic. In addition, carriers of sickle cell should avoid prolonged underwater swimming and extreme endurance tests (e.g. in the armed forces) especially in tropical conditions.
Occasionally, a little blood may appear in the urine. This usually stops on its own and is said to be of no importance. However, if you do see blood in your urine you should tell your doctor, to be sure that there is not another, more important cause.
Why is it important to know you carry sickle cell?
Though carrying Sickle cell trait does not affect their own health, carriers risk having a child with a serious haemoglobin disorder. This can happen only if their partner is also a carrier. It is important to know about this risk, because it can be avoided.
If your patient has a partner and is thinking of having children, it is important for your patient to tell the partner about Sickle cell trait, and ask him or her to have a blood test for haemoglobin disorders.
If this test shows the partner is not a carrier, there is no risk of having a child with a serious haemoglobin disorder. If the test shows the partner is a carrier, the couple should be referred to a specialist sickle cell counsellor, to discuss their reproductive options, including prenatal diagnosis.”
Is there anything else your patient should do now?
If your patient has brothers or sisters or children, they may also carry sickle cell trait. They should be offered a blood test.
