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Diagnostic Tests: Sickled Cells
Overview — What This Is
The image shows sickled red blood cells, which are elongated, crescent-shaped RBCs formed due to polymerization of abnormal hemoglobin (HbS). Sickled cells are rigid, fragile, and prone to causing vaso-occlusion and hemolysis.
Diseases Associated With Sickled Cells
Sickled cells are seen only in:
Sickle Cell Disease (HbSS — Homozygous)
Important distinction:
Most Accurate Diagnostic Test
The most accurate test for diagnosing sickle cell disease is:
Hemoglobin Electrophoresis
This test identifies and quantifies hemoglobin variants and will show:
Electrophoresis provides definitive confirmation and distinguishes SS from AS and other hemoglobinopathies.
Overview — What This Is
The image shows sickled red blood cells, which are elongated, crescent-shaped RBCs formed due to polymerization of abnormal hemoglobin (HbS). Sickled cells are rigid, fragile, and prone to causing vaso-occlusion and hemolysis.
Diseases Associated With Sickled Cells
Sickled cells are seen only in:
Sickle Cell Disease (HbSS — Homozygous)
- Patients with homozygous hemoglobin S (SS) produce sickled cells, especially during episodes of dehydration, acidosis, hypoxia, or infection.
- These patients exhibit hemolytic anemia, vaso-occlusive crises, acute chest syndrome, splenic infarction, priapism, and other complications.
Important distinction:
- Sickle Cell Trait (AS — Heterozygous) does not produce sickled cells on a routine peripheral smear.
Individuals are generally hematologically normal, though they may sickle under extreme conditions (e.g., severe hypoxia).
Most Accurate Diagnostic Test
The most accurate test for diagnosing sickle cell disease is:
Hemoglobin Electrophoresis
This test identifies and quantifies hemoglobin variants and will show:
- HbS predominates in sickle cell disease (SS)
- A mixture of HbA and HbS in sickle cell trait (AS)
Electrophoresis provides definitive confirmation and distinguishes SS from AS and other hemoglobinopathies.
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