A rare presentation of sickle cell disease diagnosed for the first time in a 60-year-old female: A misdiagnosis or missed diagnosis

Abstract

Sickle cell disease (SCD) mainly manifests in early childhood. During the first 6 months of life, infants are largely protected by high levels of hemoglobin F; soon thereafter, the disease becomes evident in form of various crises such as vaso-occlusive crisis, hemolytic crisis, and acute chest syndrome, and in rare instances aplastic crisis. Therefore, the majority of patients with SCD are diagnosed in childhood or adulthood, whereas those with sickle cell trait usually remain asymptomatic. However, here, we are presenting a rare case in which a patient has been diagnosed to have SCD for the 1st time at the age of 60 years while being treated for dengue and severe anemia. Our case is one of the rare presentations of SCD, as she never required any blood transfusions even during childbirth and without any sickle crises; therefore, she might not be diagnosed with SCD till her presentation to our hospital. This indicates that advanced age should not be considered as an exclusion criterion for the suspecting and diagnosis of SCD. This case outlines the need for awareness and incorporation of screening for sickle cell anemia in childhood or adulthood as same thalassemia screening programs. The early diagnosis by screening programs will ensure appropriate treatment and therefore improve the quality of life in such patients.