Normocytic Anemias Hematology Review 308
HEMOGLOBIN
ANEMIA ETIOLOGY BLOOD SMEAR ELECTROPHORESIS OTHER
Sickle cell
anemia (SS)
Sickle cell
trait (AS)
Hemoglobin C
disease (CC)
Inheritance of sickle cell
gene from both parents.
Valine substituted for
glutamic acid in 6th
position of bchain.
Inheritance of sickle cell
gene from 1 parent.
Inheritance of gene for
Hgb C from both parents.
Lysine substituted for
glutamic acid in 6th
position of bchain.
Aniso, poik, sickle cells,
target cells, nRBCs,
HJ bodies, basophilic
stippling, siderotic gran-
ules, polychromasia.
Occasional target cells. No
sickle cells unless hypoxic.
Many target cells, folded
cells, occasional Hgb C
crystals.
≥80% S, 1%–20%
F, normal A 2 , no A
50%–65% A,
35%–45% S,
normal F, N to
slightly ↑A 2
>90 C, <7% F, no A
Hgb S polymerizes under ↓O 2
& ↓blood pH. Disease not
evident in newborn because
of ↑Hgb F. Pos solubility test.
Retics 10%–20%. May have
↑WBC with shift to left &
↑PLT. Moderate to severe
anemia.
No anemia. Pos solubility test.
Important to Dx for genetic
counseling.
Mild to moderate anemia.
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