Sickle cell: stress, environmental factors may trigger crisis-Hematologist

On Jun 21, 2023

A Consultant Haematologist at the Ogun State General Hospital, Dr. John Oguntade has identified stress, and extreme weather conditions as key factors that may trigger health crises in people with sickle cell anaemia. He disclosed this to newsmen in commemoration of the 2023 World Sickle Cell Day. The theme of this year’s World Sickle Cell Day is ‘Building and Strengthening Global Sickle Cell Communities, Formalising New-born Screening and Knowing your Sickle Cell Disease Status’.

The medical expert noted that lack of oxygen can lead to fatigue, pain flare-ups, shortness of breath, and other health issues in people with sickle cell.

According to him, individuals with sickle cell inherited a haemoglobin trait that makes them react under hypoxic conditions (when there is a lack of oxygen caused by low oxygen tension).

Also, the Centre for Disease Control and Prevention explained that Sickle Cell Disease is a group of inherited red blood cell disorders. The agency explained that red blood cells contain haemoglobin, a protein that carries oxygen, adding that healthy red blood cells are round, and they move through small blood vessels to carry oxygen to all parts of the body.

The specialist said sickle cell patients who also have other underlying medical conditions need to be cautious of their surroundings and must stay away from harsh environments.

He said: “The patients are unable to handle stress because of their inherited haemoglobin trait, which is easily polymerized when under hypoxic conditions. Any slight deviation from the norm, such as extreme temperature, either hot or cold, can trigger their crisis. Additionally, any other disease that may not be as pronounced in a person without it could also cause crisis. When in a harsh environment, their already weakened red blood cells are put under further stress by a shortage of oxygen, which raises the possibility of vaso-occlusive crises. Red blood cells with a sickle shape clog blood arteries, causing severe pain, organ damage, and other grave problems. High-altitude travel is particularly harmful to those with SCD due to the combination of oxygen deprivation and the innate tendency of sickle cells to clump together under stress,” he added.

While advising AS carriers not to marry each other, the expert said: “When we have two people who have this type of mutation, as in AS, getting together to marry, they have a one in four chance of having an offspring who is SS. This is one in four possibilities in every conception, not one in four children. Now, when it is heterozygous; that is when you have both A and A, it is not as noticeable because the A that the haemoglobin makes would act as a buffer. However, when both are SS, then, that is when a crisis arises. Therefore, the double S gene that is inherited from both parents is the true source of the problem. My advice to intending couples is to give it some serious thought. However, during therapy, you don’t have the right to persuade somebody not to get married, instead, you must inform them of the potential repercussions. It is taxing psychologically and financially, and it is difficult to deal with socially,” he stated.

The World Health Organisation revealed that over 300,000 babies globally are born annually with sickle cell disorders with over 75 per cent of cases in sub-Saharan Africa.

Wumi/Punch