SICKLE CELL ANEMIA

SCIENCE

GENETICS

This Punnett square shows the chances of SCA, and it is recessive.

This Punnett square shows the chances of SCA, and it is recessive.

This pedigree presents SCA in an
autosomal recessive pattern.

This pedigree presents SCA in an
autosomal recessive pattern.

This shows the inheritance of the normal 
versus sickle hemoglobin being passed on. 
(More info in the side three lines)

This shows the inheritance of the normal
versus sickle hemoglobin being passed on.
(More info in the side three lines)

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In the image, each parent has one normal hemoglobin A gene and one hemoglobin S gene, which means each of their children has:- A 25% chance of inheriting two normal hemoglobin A genes. In this case, the child does not have sickle cell trait or disease.- A 50% chance of inheriting one normal hemoglobin A gene and one hemoglobin S gene. This child has sickle cell trait.- A 25% chance of inheriting two hemoglobin S genes. This child has sickle cell disease.

Mutation that causes SCA

Complications because of SCA

Acute Chest Syndrome (ACS)

Pulmonary Hypertension

Pulmonary Hypertension

Organ Damage

Leg Ulcers

Priapism

Stroke

Symptoms

Anemia

Episodes of pain

Vision Problems

Frequent Infections

Delayed growth and puberty

Swelling of hand and feet

Subtopic

SOCIETY

Living with SCA

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Living with SCA is a challenge depending on your living situation. All of these factors are dependent on each other one way or another. An example of this is managing pain, to manage pain having a healthy lifestyle and following up on your care is key.

Routine Follow Up Care

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Making sure you have routine follow up care is very important for people who have SCA because if you have pain or if you are on medications to help your pain you want to make sure everything is healthy to avoid any crises. Getting vaccines is also very important as you don't want your systems compromised.

See your doctor regularly

See your doctor regularly

Get your vaccines

Get your vaccines

Managing Pain

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Managing pain is key in Sickle Cell Anemia as pain episodes can be terrible for those who suffer from it and can be life threatening. The following below and ways to maintain a healthy lifestyle and to be careful especially when you are going through a pain episode or if you know that a pain episode might be coming.

Drink Plenty Fluids

Drink Plenty Fluids

Avoid Extreme Temperatures

Be careful with high altitudes

Avoid Alcohol and Smoking

Avoid Alcohol and Smoking

Adopting a healthy lifestyle

Regular Exercise, Making sure
it is not too strenous

Regular Exercise, Making sure
it is not too strenous

Eating Well

Eating Well

Psychological Causes

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Sickle Cell Anemia has many psychological effects on people as they have a hard time living with it and the lack of knowledge contributes to the different psychological issues.

Self-Isolation among adolescents

Self-Isolation among adolescents

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 The tendency to self-isolate due to a lack of understanding about SCD and the debilitating nature of pain crises amongst friends and family members further add to the social and economic consequences of SCD.

Anxiety

Depression

Depression

Sickle Cell Awareness Month

Every September, it is sickle cell 
awareness month with a goal to raise 
awareness about it and how it impacts many people.

Every September, it is sickle cell
awareness month with a goal to raise
awareness about it and how it impacts many people.

It is represented by the colour burgundy

It is represented by the colour burgundy

What is Sickle Cell Anemia/Sickle Cell Disease

A genetic disorder that is caused by a defect on chromosome 11.

Description of Sickle Cell Anemia

Inherited red blood cell disorder in which there aren’t enough healthy red blood cells to carry oxygen throughout your body

The red blood cells are shaped like “crescent moons”

These rigid, sticky cells can get stuck in small blood vessels which can slow or block blood flow and oxygen to the body.

TECHNOLOGY

Diagnoses

Blood Test

Blood Test

Newborn Screening

Newborn Screening

Amniocentesis

Amniocentesis

Chorionic Villus Sampling (CVS)

Chorionic Villus Sampling (CVS)

TREATMENT

Medications/Drug Therapy

Hydroxyurea (Droxia, Hydrea, Siklos)

Hydroxyurea (Droxia, Hydrea, Siklos)

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Helps reduce how frequent pain episodes occur and lower the need to do a blood transfusion/hospitalization. Can increase risk of infections, Should not be taken if pregnant. 

Endari (L-glutamine oral powder)

Endari (L-glutamine oral powder)

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Helps reduce pain crisis frequency. 

Adakveo (Crizanlizumab)

Adakveo (Crizanlizumab)

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Reduce pain crisis frequency, Side effects include; nausea, joint pain, back pain and fever. (Injected) 

Voxelator (Oxybryta)

Voxelator (Oxybryta)

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Oral Drug to improve anemia. Side effects; headache, nausea, diarrhea, fatigue, rash and fever. 

Surgical Procedures

Blood Transfusions

Blood Transfusions

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Red blood cells are removed from a supply of donated blood, then given through a vein to a person with Sickle Cell Anemia. Increases the number of normal blood cells which help reduce complications and symptoms. Risks include: immune response to the donor blood - makes it hard for future donors, infection and excess iron build up - too much iron can damage heart, liver and other organs and if you go through regular transfusions, you should lower iron levels. 

Stem Cell Transplant

Stem Cell Transplant

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Procedure involves replacing the bone marrow that is affected by sickle cell anemia with healthy bone marrow from a donor. There are significant risks associated with a bone marrow transplant, the procedure is recommended for children that have major symptoms and complications because of it. After the transplant, you will have anti rejection medications to prevent the rejection of the donated stem cells. If your body rejects the transplant, it can lead to life-threatening complications. 

Experimental Treatments

Gene Therapy

Gene Therapy

Nitric Oxide

Nitric Oxide

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Those that are affected by Sickle Cell Anemia show low levels of nitric oxide in their blood. Nitric Oxide is a gas that helps keep blood vessels open and reduces the stickiness of red blood cells. The experimental treatment with this is inhaling nitric oxide which might prevent sickle cells from clumping together. (Not much progress seen with this new therapy)

Drugs to boost
fetal hemoglobin
production

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Researchers are looking for different drugs and ways to improve hemoglobin in the fetus to avoid the sickle cells from forming.

ENVIRONMENT

TEMPERATURE

Many people with SCA Live in tropical countries

Many people with SCA Live in tropical countries

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Temperature plays a role in your well being with SCA. Studies show that the exposure to cold or to wind increases the hospital attendance because of acute pain. Cold and Rainy seasons have also seen an increased frequency of patients who suffer from pain. This pain is also caused by other environmental factors as well such as housing, socio-economic status and air quality.While it may seem that cold weather may be the only contributor, it is not. Warm climate also had similar reports yet less than colder weather. Humidity and excessive heat did also report acute pains.

hemoglobin molecules stick to each other forming rod-like long structures. Leads to blood cells becoming sickle shape, this causes blockages and damaging vital organs and tissues. (hemoglobin-S)

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Additional Information Mutations in the gene cause a problem when oxygen levels in the blood are lower Occurs once hemoglobin has delivered oxygen to the cells in the body’s tissuesIf there is less oxygen, the hemoglobin-S gene (which is the mutated gene) can cause rigid, non-liquid protein strands to form which then change the shape of the cell in the blood cell. The lack of oxygen in tissue can cause attacks of sudden severe pain, called pain crises. These pain attacks can occur without warning, and a person who has them often needs to go to the hospital for effective treatment.

This image demonstrates the difference between Normal and Sickle Hemoglobin Cells and how the blood cells are different after

This image demonstrates the difference between Normal and Sickle Hemoglobin Cells and how the blood cells are different after the mutation.

Did you know that about 1 in 12 African and about 100 Hispanic Americans carry the sickle cell trait

Some connections are made based on the additional information (the three lines)

Point Mutation (Info in the side)

Point Mutation (Info in the side)

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Inherited genetic disorder caused by a point mutation in the gene that encodes the  β-globin chain of hemoglobin (Hbβ)Two β-globin chains and two α-globin chains form hemoglobin, the multisubunit protein in red blood cells that carries oxygen. This mutation ends up replacing the negatively charged glutamate by a neutral hydrophobic valine that produces sticky patches on the protein surface. Upon delivering oxygen to the tissues, the mutant hemoglobin (HbS) polymerizes into fibers, which distort (“sickle”) red blood cells and cause blockage of the circulation, resulting in acute, severe pain called a sickle cell crisis. 

Normal VS Sickle Cells

NORMAL

NORMAL

transports oxygen from the lungs to other parts, red blood cells are smooth and round which glide through blood vessels (hemoglobin-A)

SICKLE

SICKLE

Results of the Point Mutation

Lung Tissue Damage

Lung Tissue Damage

Acute Chest Pain

Pain Episodes

Stroke

Priapism

Can cause damage to: