SAMUEL CHARACHE, M.D.
To the editor: The "natural history" of sickle cell anemia in Saudi Arabs (Ann Intern Med 88:1-6, 1978) is certainly different from the disease as we see it in the United States but not as different as Table 2 in Perrine's paper would suggest. There is a paucity of good data, but 44% of all patients in Baltimore do not have ankle ulcers, 17% of all patients older than 5 years of age do not have hemiplegia, and 13% of all patients have not had osteomyelitis. The series quoted in Reference 12 probably includes patients with "tropical ankle ulcers," which
CHARACHE S. Sickle Cell Anemia. Ann Intern Med. ;89:145. doi: 10.7326/0003-4819-89-1-145_1
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Published: Ann Intern Med. 1978;89(1):145.
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