Sickle Cell Anemia

[Uneekeye]

I'm currently an LPN and in my second year of nursing school and no one has been able to answer this question for me. I've looked online and can't find this information.

Will the Hgb with a patient in Sickle Cell Crisis be decreased or stay relatively the same since it is not necessarily only measuring HgbA. I understand that Hgb Electrophoresis differentiates between Hgb S and Hgb A. But what does the normal Hgb lab results do? Help...

[himilayaneyes]

I can't get technical with you as far as what type of hgb b/c when you check a patient's labs on the floor there is only one Hgb. Most sicklers have low hemoglobins....hence sickle cell anemia. The normal lab Hbg as far as I know doesn't differentiate anything...it just tells you the patient's hemoglobin level...hemoglobin carries oxygen.

[mandyc]

From what I "understand" if a person does have sickle cell anemia, it will show in the production of their RBC. For instance, a normal RBC will live approx. 120 days while a sickle cell RBC will only live approx. 10-20 days. The body cannot produce healthy RBC to the extend of the death of the mutated cell. (can clog spleen, ....etc) With that said, I would imagine that it would show low levels of both Hgb and RBC counts. It should also show in the oxygen transportation, meaning decrease O2 saturation during sickle cell crisis. (which I am sure you already know, given your statement) Also when a CBC is done they also do a Mean corpuscular volume (MCV) this is a measurement of the size of the red blood cells. A low MCV is often the first indication of thalassemia. If the MCV is low and iron-deficiency has been ruled out, the person may be a thalassemia.

http://www.labtestsonline.org/understanding/analytes/hemoglobin_varho/glance-3.html

I hope this helps a little...I just did a research paper on sickle cell anemia.

[noahsmama]

Hgb of sickle cell patients tends to be low and they generally need periodic transfusions to boost their Hgb back up. I'm not sure if this correlates with when the pt has sickle cell pain crisis though. I've had pts in sickle cell pain crisis whose Hgb was high enough that they did not require transfusions, I've also had pts who were in for a transfusion only (as an outpatient), and not in pain crisis.

[classicdame, MSN, EdD]

the pain is caused by the sickle shaped cells getting caught going around tight spaces and congregating, causing decreased O2 and maybe even a thrombus.

[Frozen08]

Sickle Cell Anemia Hgb lab values can vary, and should not necessarily determine treatment course.

Most lab Hgb machines use a Cyanide-Hgb binding spectrophotometry to determine its concentration in blood. In cases of sickle cell, there is often a great deal of hemolysis going on in the spleen, liver, and other body systems, this can cause hemoglobinemia which still binds to cyanide and registers as "hemoglobin" on the print out, thus falsely showing normal or even levels of Normal RBC hemoglobin concentraions.

So the answer is: It can be either raised, lowered, or the same. Patients should be treat based on Signs and Symptoms, not lab value.

[paceurself]

I work at the Meharry Sickle Cell Center. The hemoglobin will be less if a person is in crisis, usually around 6 or 7; but hemoglobin lab value looks at how much not what the content is. If a person has SS, that means they have no hemglobin A at all. I hope this helps.