Causes and management of sickle cell disease

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Sickle cell disease (SCD) is a genetic condition that affects the red blood cells, which carry oxygen throughout the body.

This review explains what causes sickle cell disease, how it affects individuals, and what can be done to manage it, using straightforward language to make the information accessible to everyone.

Sickle cell disease is caused by a mutation in the gene that tells the body how to make hemoglobin, the protein in red blood cells that carries oxygen.

The mutation causes the hemoglobin to form into stiff rods within the red cells, making them shaped like a sickle or crescent moon, rather than the normal round shape.

These sickle-shaped cells are not flexible and can get stuck in blood vessels, blocking blood flow. This blockage can cause pain, infections, and organ damage.

SCD is inherited, which means it is passed from parents to children through genes. Each parent carries one sickle cell gene and one normal gene. When a child inherits the sickle cell gene from both parents, they have SCD.

If they inherit one sickle cell gene and one normal gene, they carry the sickle cell trait, which means they usually don’t show symptoms of the disease but can pass the gene to their children.

People with SCD often suffer from episodes of pain called sickle cell crises, which occur when the sickled cells block blood flow to limbs and organs, causing pain and organ damage. These crises can be triggered by various factors, including temperature changes, stress, dehydration, and high altitudes.

Over time, SCD can lead to complications like hand-foot syndrome, where the hands and feet swell due to blocked blood flow, acute chest syndrome, stroke, and organ damage. Children with SCD are also at increased risk of infections and delayed growth.

There is no universal cure for SCD, but treatments can help manage and reduce symptoms and complications. The most common treatment is hydroxyurea, a medication that helps reduce the number of sickle cell crises by making the red blood cells larger and more flexible.

This medication can also reduce the need for blood transfusions, which are sometimes used to treat severe anemia in people with SCD.

Bone marrow or stem cell transplants can cure SCD, but they are risky procedures and not an option for everyone.

These transplants involve taking stem cells from a healthy donor’s bone marrow (usually a sibling who is a match) and transferring them to the patient. The new stem cells can produce normal red blood cells, effectively curing the disease.

Regular check-ups are crucial for managing SCD, as they allow healthcare providers to monitor the condition and prevent serious complications. Vaccinations, antibiotics to prevent infections, and pain management are also integral parts of treatment.

Additionally, lifestyle changes like drinking plenty of water, avoiding extreme temperature changes, and getting regular exercise can help reduce the risk of a sickle cell crisis.

Awareness and understanding of SCD are essential for managing the disease effectively. Family education about the genetic risks and the importance of genetic counseling is also crucial for managing the condition in families affected by SCD.

With ongoing research and improvements in care, people with SCD can lead fuller, longer lives. This review aims to inform and empower patients and families dealing with sickle cell disease by providing clear and useful information about its causes, effects, and management.

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