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Sickle-Cell Trait: Benign or Malignant?

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The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, N.C.

Ann Intern Med. 1972;77(6):997-998. doi:10.7326/0003-4819-77-6-997
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Despite the specificity of the molecular defect in hemoglobin S, the consequences of having this abnormal hemoglobin may show extreme variations in clinical expression in the same patient as well as among different affected individuals. Hemolysis is consistently present, but infarction and thrombosis are occasional or intermittent phenomena. Additional factors must coexist with the hemoglobin S to modify its phenotypic expression.

Even greater variability in clinical expression is found in individuals heterozygous for hemoglobin S, in whom the percentage of abnormal hemoglobin ranges from 22% to 45%, with an average of 40% (1). Sickle-cell trait was once considered to be


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