Diagnostic value of anemia, red blood cell morphology, and reticulocyte count for sickle cell disease. Ann Emerg Med 1992 Aug;21(8):915-8
Date
08/01/1992Pubmed ID
1497156DOI
10.1016/s0196-0644(05)82927-0Scopus ID
2-s2.0-0026769252 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
STUDY OBJECTIVE: To determine the diagnostic value of anemia, RBC morphology, and reticulocyte count for differentiating patients with sickle cell trait from those with sickle cell disease, who have acute medical or surgical conditions and a positive sickle cell screen.
DESIGN: Retrospective chart review.
SETTING: A midwest urban children's hospital with 220 beds and 36,000 emergency department visits per year.
PARTICIPANTS: One hundred six patients with sickle cell trait and 152 patients with sickle cell hemoglobinopathies.
RESULTS: Anemia was observed significantly more often in patients with sickle cell disease compared with sickle cell trait (P less than .001) at all ages 3 months and older. However, anemia alone as a diagnostic test lacked high sensitivity and specificity in children less than 4 years old. Sensitivity approached 100% with the presence of anemia, abnormal RBC morphology, or reticulocyte count of more than 2%.
CONCLUSION: Absence of anemia alone does not exclude the diagnosis of sickle cell disease in children less than 4 years old. To differentiate trait from sickle cell disease, we recommend determination of not only hemoglobin adjusted for age but also of RBC morphology and reticulocyte count on all children presenting with acute medical and surgical conditions and a positive sickle cell screen.
Author List
Losek JD, Hellmich TR, Hoffman GMAuthor
George M. Hoffman MD Chief, Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAnemia
Anemia, Sickle Cell
Child
Child, Preschool
Diagnosis, Differential
Erythrocyte Count
Erythrocytes
Female
Hemoglobins
Humans
Infant
Male
Reticulocytes
Retrospective Studies
Sensitivity and Specificity
Sickle Cell Trait
