SIGNS AND SYMPTOMS: Sickle cell trait is a haemoglobin genotype AS is generally regarded as a benign condition (Roach, 2005). However, individuals with sickle cell trait may have rare complizations. Calls have been made to re-classify sickle cell trait as a disease state because of its malignant clinical presentations.
- Renal medullary carcinoma, a cancer affecting the kidney is a very rare complication seen in patients with sickle cell trait.
- Hematuria in sickle cell trait, microscopic or gross hematuria is an uncommon problem in individuals with sickle cell trait occurring in 1 to 4% of individual with HbAS when it occurs, it tends to be recurrent and can be severe and persistent, iron deficiency, renal obstruction, infection and other complications occur.
- Renal papillary necrosis only considered possible by some source (Many-louse and Turgeon, 2005).
- Splenic infarcts at high altitude and surgery may not always be necessary.
- Urinary tract infection
- Sudden death during physical exertion in black united state army recruits.
- Complicated hyphema, venous thromboembolic events, fetal pre-eclampsia, Acute chest syndrome, assymptomatic bacteria and anaemia in pregnancy.
- Insufficient evidence retinopathy, cholelithiansis, priapism, leg ulcers, lever necrosis, avasiular necrosis of the femoral head and stroke (Birnabaum and pinzone, 2008).
- In some cases, athletes with sickle cell trait do not achieve the same level of performance as elite athletes with normal hemoglobin AA. Athletes with sickle cell trait and their instructors must be aware of the dangers of the condition during anaerobic exertion especially in hot and dehydrated conditions.
- There have been reports of pulmonary venous thromboembolism in pregnant women with sickle cell trait or men during prolonged air flight, mild strokes and abnormalities on PET scans in children with the trait.
- In a rare cases, exercise induced dehydration or exhaustion can cause healthy red blood cells to turn sickle shaped which can cause death during sporting activities, Sickle cell trait appears to worsen the complications seen in diabetes mellitus type 2 (retinopathy, nephropathy and proteinuria) and provoke hyperosmolar diabetic coma, nephroputhy especially in male patients (Ajayi and kolawale, 2004).
DIAGNOSIS (LABORATORY DIAGNOSIS)
Sickle cell trait individual has no physical findings that can be attributed to sickle cell trait. The diagnosis of sickle cell trait is established by an electrophoresis, Isoelectric focusing or high performance liquid chromatography (HPLC) result that shows HbAS with about 55% HbA and 45% of Haemoglobins. Haemoglobin, reticulocyte count, and all laboratory tests are normal with sickle cell trait.
People who are known carriers of the disease often undergo genetic counseling before they have a child, A test to see if an unborn child has the disease takes either a blood sample from a foetus has greater risks, the later test is usually used (Clarke and Higgins, 2000).
Treatment first requires a complete evaluation to exclude other causes of hematuria including cystitis, bladder and renal tumors. Urine culture is always indicated. There is some evidence that medullary carcinoma of the kidney is more common in individuals with HbAS.
Initial treatment includes bed rest, vigorous oral hydration, administration of sodium bicarbonate to alkalinize the urine and diuretics and potassium if required. Individuals with persistent are admitted for strict bed rest and intravenous hydration with alkaline diuresis.
Urologic intervention may be beneficial however; nephrectomy to control bleeding is almost never indicated because of the high probability of recurrence in the contralateral kidney (Sheikha, 2005).