BICARBONATES, pH AND PERCENTAGE OF SICKLED CELLS IN VENOUS BLOOD OF PATIENTS IN SICKLE CELL CRISIS

Irreversibly sickled erythrocytes: a consequence of the heterogeneous distribution of hemoglobin types in sickle-cell anemia

“…We suggest that, in accord with the concept of erythrostasis advanced by Ham and Castle (24), a small select population of Hb SS erythrocytes has a predilection for occluding small vessels; and if the shortest lived red cells are most culpable in the consequent production of crises and organ damage characteristic of Hb SS disease, ISC may constitute this small select population. Barreras and Diggs (25) noted that the proportion of sickled forms in formalin-fixed venous blood tended to decrease during the course of crises, but in agreement with Jensen, Rucknagel, and Taylor (26) they found no correlation between the proportion of sickled forms and the long-term course of the disease. Here the adjective "sickled" must be employed with caution.…”

Quantification of Sickle Cells in the Peripheral Smear as a Marker of Disease Severity

“…Sickle cells may constitute about 5-50% of the total number of red cells in the peripheral smear [2]. The literature suggested that there is a decrease in the number of sickle cells during a painful episode [7][8][9]. Other investigators did not find an association between the number of sickle cells and clinical characteristics or differences between the steady-state and during the acute pain episode [10][11][12].…”

Acid-Base Status of Adults with Sickle-cell Anaemia

“…The excruciating pains in the back, abdomen, chest, and limbs, accompanied by fever, have been well described (Diggs, 1965). Metabolic acidosis has been incriminated as the initiating cause of these painful crises (Diggs, 1965), and a report of 17 consecutive cases in painful crisis has noted that a severe metabolic acidosis was consistently present (Barreras and Diggs, 1964). It is also known that painful crises can be produced experimentally by the prolonged administration of ammonium chloride (Greenberg et al, 1957;Barreras and Diggs, 1964).…”

“…It is also known that painful crises can be produced experimentally by the prolonged administration of ammonium chloride (Greenberg et al, 1957;Barreras and Diggs, 1964). As a result, the use of alkalis for the treatment and prevention of painful crises has been unversally advocated (Greenberg et al, 1957;Greenberg and Kass, 1958;Nwokolo, 1960;Barreras and Diggs, 1964 al., 1964). Our experience in Jamaica, however, has made it clear that treatment with alkalis does little to abort or shorten the duration of the painful crises.…”

“…Metabolic acidosis has been incriminated as the initiating cause of these painful crises (Diggs, 1965), and a report of 17 consecutive cases in painful crisis has noted that a severe metabolic acidosis was consistently present (Barreras and Diggs, 1964). It is also known that painful crises can be produced experimentally by the prolonged administration of ammonium chloride (Greenberg et al, 1957;Barreras and Diggs, 1964). As a result, the use of alkalis for the treatment and prevention of painful crises has been unversally advocated (Greenberg et al, 1957;Greenberg and Kass, 1958;Nwokolo, 1960 al., 1964).…”