RETICULOCYTOPENIA IN SICKLE CELL DISEASE. APLASTIC EPISODES IN THE COURSE OF SICKLE CELL DISEASE IN CHILDREN.

Abstract

Temporary failure of red cell production has been well documented in hematologically normal persons, usually in association with infection, allergy, or a toxin. 1,2 The brief duration of these episodes (seven to 14 days) in comparison to the relatively long life span of the normal erythrocyte (120 days) results in only a mild, transient, and usually unimportant drop in hemoglobin concentration. The same temporary failure in a patient with a congenital hemolytic anemia, on the other hand, is a dramatic event. In sickle cell disease, where the mean red cell life span has been estimated to range from 6 to 21.5 days 3,4 the same aplastic episode can result in a precipitous fall in hemoglobin to as low as half the steady state level over a two to seven day period. Thus a child who has maintained his hemoglobin at 6 gm% by a continuous brisk reticulocytosis may present with