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Sickle cells are not necessarily protective against falciparum- A case report
Jess Elizabeth Rasalam1, Snehil Kumar1, K Sujith2, NA Fouzia2, Arpana Palle1, Dolly Daniel1, Sukesh Chandran Nair1
1 Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Clinical Haematology, Christian Medical College, Vellore, Tamil Nadu, India
Correspondence Address:
Jess Elizabeth Rasalam,
Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/ajts.ajts_122_21
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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.
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