Sickle cells are not necessarily protective against falciparum- A case report

• Published in: Asian journal of transfusion science Vol. 16; no. 2; pp. 266 - 268
• Main Authors: Rasalam, Jess, Kumar, Snehil, Sujith, K, Fouzia, N, Palle, Arpana, Daniel, Dolly, Nair, Sukesh
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-07-2022; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Anemia; Blood transfusions; Case Report; Case reports; Erythrocytes; hemolysis; Malaria; Pediatrics; Sickle cell anemia; Sickle cell disease; sickle cell diseases; Hemolysis; sickle cell diseases; malaria
• ISSN: 0973-6247; 1998-3565
• DOI: 10.4103/ajts.ajts_122_21

The relation between sickle cell disease (SCD) and malaria is captivating where sickling of the infected red blood cells (RBCs) causes premature hemolysis and parasite death. Although patients with sickle cell trait are relatively protected, malaria can often lead to marked anemia in them due to hemolysis. We report an unusual case of a child with homozygous SCD presenting with falciparum malaria and had hyper parasitemia and severe anemia which completely resolved following treatment. Clinical suspicion in our case arose considering the endemic nature of malaria in our country. The two overlapping injuries to spleen reduced the clearance of parasites by the spleen as evidenced by high parasite load. Our case report reinforces malaria as a cause of clinical worsening of SCD and highlights the importance of a multifactorial approach in the management of worsening anemia in SCD.