Peripheral blood smears of 7 adult patients with sickle cell disease who were admitted to Kern Medical Hospital during the period of March 2024 to July 2024 were examined. Six patients had sickle cell SS disease and 1 patient hemoglobin SC disease. All had acute vasoocclusive painful episodes. All patients have been taking hydroxyurea except one patient who was nursing her baby after recent delivery by cesarean section. She did not take the hydroxyurea for prior 10 months.
Total 14 slides of the 7 patients were examined under the high power field and their pictures photographed. About 5% of all red blood cells (RBCs) had abnormal morphologies. None of the patients who were taking hydroxyurea had the typical elongated crescent-shaped sickle cells. The abnormal RBCs seen in the blood smears have the shapes of canoe or spindle (20%), thick lips (20%), coffee bean (20%), pea pod (20%), rod (10%), and others such as fragmented helmets or teardrops (10%). However, the patient who had not been taking hydroxyurea had a few atypical sickle cells. The disappearance of the typical sickle cells and appearance of various abnormal shapes of RBCs may be the effect of hydroxyurea which increases the level of the hemoglobin F and subsequently reduced degree of polymerization. Conclusion: The peripheral blood smears of patients with sickle cell disease who were taking hydroxyurea showed various shapes of RBCs, but not the typical elongated crescent-shaped sickle cells. However, one patient who was off hydroxyurea for prior 10 months had a few atypical sickle cells. The disappearance of the typical sickle cells and appearance of RBCs of various abnormal morphologies may be due to hydroxyurea therapy.
No relevant conflicts of interest to declare.
This feature is available to Subscribers Only
Sign In or Create an Account Close Modal