Abstract
Answer C. Sickle cell anaemia
Sickle cell anaemia is a relatively common disorder and should be suspected in infants from high-risk communities. Neonatal screening is important and GPs should ensure that infants are offered screening. Patients usually present in infancy with infection, jaundice and failure to thrive. Babies are found to have normocytic normochromic anaemia. Haemoglobin A and F levels should be checked. There is also a raised lactate dehydrogenase, unconjugated hyper-bilirubinaemia and reticulocytosis. Sickle cells as well as target cells can be seen on blood film. Leucocytosis and thrombocytosis are from the chronic inflammatory state. Patients with thalassaemia usually have a reduced mean cell volume (but can be normal) and a high haemoglobin A level. Breast feeding can cause a high bilirubin in the first week of feeding, but not this late on. Blood loss will usually present with a low mean cell volume (microcytosis) and vitamin B12 deficiency typically shows as a high mean cell volume (macrocytosis).
InnovAiT article: Sickle cell disease. DOI: