Clinical and hematological parameter alterations found in sickle cell anemia heterozygotes in Brazil
Heterozygosis for the hemoglobin S allele is a relatively common condition that is clinically benign and rarely presents clinical or hematological manifestations. Although rare, symptoms have been reported in these patients. We examined clinical manifestations and laboratory findings in HbAS individuals that could be related to the βS haplotypes: in 31 heterozygotes, with a predominance of females and young adults, and 43 AA homozygotes considered as a control group from samples previously stored in our laboratory. We performed clinical, biochemical and hematological tests, as well as genotyping by PCR-RFLP for the identification of βS haplotypes. Bantu and Benin haplotypes were equally frequent (n= 7, each) and 17 individuals had shown atypical haplotypes. We observed hematological alterations (e.g. mean corpuscular volume levels) that suggest microcytic and hypochromic anemia; however, we did not find iron deficiency anemia or thalassemia. In the clinical examination, the heterozygote individuals reported pain, especially in the upper and lower limbs and joints, as the most frequent complaint. HbS heterozygotes, different from literature reports, had a significantly greater frequency of anemia-related parameters when compared to normal homozygotes.