Case Study of Sickle Cell Anemia Assignment

Running head: CASE STUDY OF SICKLE CELL ANEMIA
Case Study of Sickle cell Anemia
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Author Note

CASE STUDY OF SICKLE CELL ANEMIA1
Abstract
Anaemia is a significant cause of morbidity and mortality worldwide, and it is said to be
caused by a decreased amount of circulating red blood cells. Laboratory parameters support
the diagnosis of patients with anemia shoyld. The purpose of this paper is to discuss the
clinical approaches which are useful for evaluating the patient with anaemia. This is a case
study of a four years old male child diagnosed with sickle cell anaemia suffering from fever
and joint pain. Several laboratory tests were performed with the venous blood sample
collected from the patient. The peripheral blood smear showed the presence of
normochromic, normocytic anaemia which signified that the count of haemoglobin and RBC
are in a normal range. The haematocrit result was performed to detect the presence of
anaemia and the decreased osmotic fragility test showed that there is no risk of haemolytic
anaemia. However, the child may suffer from either iron deficiency or sickle cell anaemia.
Finally, the haemoglobin electrophoresis test confirmed that the child has sickle cell anaemia.

CASE STUDY OF SICKLE CELL ANEMIA2
Introduction
The given case study briefs about a four years old male child who is down with fever
accompanied by headache and pain in the joints of arms and legs(Allali et al, 2017). Though
his blood pressure results were normal, it was found he was suffering from an enlarged
spleen. His mucous membrane also showed paleness with a sign of icterus in the sclera. A
venous blood sample was collected from the child for further laboratory investigations. At
first, a blood smear test was done for evaluating the RBC, WBC and platelet count within the
patient venous blood sample. It also helps to detect the range of disorders or diseases which
results from reduced or damaged blood cell production. Moreover, peripheral smear test is
crucial for patients with anaemia, as it helps to detect iron deficiency in the RBC along with
identifying the size and shape of the Red blood cells. The test is performed by making a
blood smear on a glass slide with the help of various stains such as Romanowsky stain, and
then the slides are observed under the microscope. The normochromic, normocytic anaemia
test was performed to detect the average count and the content of haemoglobin in the red
blood cells. MTT assay is a rapid colourimetric test for detecting proliferation of cell along
with cell death. It uses a dye called 3-(4,5- dimethylthiazol)-2,5- diphenyltetrazolium
bromide. This test is done to measure the viability of cells. It is a convenient and safe
technique for detecting the concentration of different mitogens for human peripheral
mononuclear cell proliferation. The hematocrit test was done to find out the percentage of red
blood cells in the patient blood(Fujiwara, Ikeda and Nakaminami, 2018). If the patient has
anaemia, then he will have a few RBCs. In the laboratory, it is usually measured with the help
of a machine that determines the complete blood count (CBC). The osmotic fragility test was
performed to measure the resistance of the red blood cells to hemolysis when exposed to
various dilution levels of saline solution. It refers to the intensity at which the erythrocytes

CASE STUDY OF SICKLE CELL ANEMIA3
lyse under stress condition. And finally, haemoglobin electrophoresis is done to detect the
various types of haemoglobin present in his blood. It uses the principle of gel electrophoresis
for separating the different types of haemoglobin.
Result
The normochromic and normocytic test(Ruddell, 2020)of the venous blood sample collected
from the child showed that the average count and content of haemoglobin within the patient
blood sample is within the normal range. It also signifies that iron is deficient in the blood.
The haematocrit test results showed a low percentage (22%) of erythrocytes. A low
haematocrit value means that the rate of RBC is below the lower limit of standard (typical
value of Hct for a child is 30-40%), which means that the child may be suffering from
anaemia. The MTT assay showed the number of viable cells and identified the proliferation
of cells. The causes of low haematocrit value may be internal bleeding, destruction of red
blood cells as in case of sickle cell anaemia or enlarged spleen, iron deficiency or small
production of RBCs(Hauser, Stemme and Roxhed, 2019). The osmotic fragility test showed a
decreasing value which signifies that hemolysis is not completed in a 0.30% NaCl
solution(Ciepiela, 2018). It means that there is increased resistance to haemolytic anaemia.
This may be associated with iron deficiency anaemia or sickle cell anaemia. Lastly, the
haemoglobin electrophoresis showed the presence of sickle cell anaemia(Válka and Čermák,
2018).