Queston about sickel cell pt's?

[toledomedic81]

Ok so in class last week we learned about the circulatory system and one of the objectives is to describe how oxygen is carried in the blood. Well while answering that i figured that For every hemoglobin there are four irons that can hold four oxygen's. Well then i thought about sickle cell patients and since the RBC shape is changed would that mean that the hemoglobin in the sickle cell patient would change too? And if it did, does that mean that each sickle cell would carry less oxygen than a normal cell, and even though SPo2 measures the oxygen in the blood in a sickle cell patient would it be decreased oxygenation at the cellular level as compared to a non-sickle cell patient or would a sickle cell patients body just create more sickle cell RBC's to compensate? Is it too much to think about or am i just being geeky

[als_medic_uk]

Patients with sickle cell anaemia have baseline [cp] anaemia, that varies in severity, usually the haemoglobin levels are between 6-9 g/L typical. Reticulocyte counts are elevated, which are indicating the new red blood cells being produced to compensate for the destroyed cells - red blood cells die much faster because of this disease. The white blood cell and platelet counts are also on the up, and these cells may also be indicative [relationally] to vaso-occlusion.

Regards

[toledomedic81]

Are the WBC elevated do to the effects of the sickle cell on the spleen? And does the shape of the sickle cell effect the about of oxygen that it can carry?

[AnthonyM83]

Yes, each sickle RBC carries less oxygen (from textbook), because of its deformity but I'm almost certain it doesn't affect WBC much content ( for details see: http://www.drspock.com/article/0,1510,5072,00.html )

[ERDoc]

Each hemoglobin molecule is made up of 4 subunits, two of which are called the beta-globin subunits. The globin molecules are proteins (which are composed of amino acids). In someone with sickle cell, one of the amino acids in the Beta-globin subunit is switched. These modified beta-globins can cause the hemoglobin molecules to clump together within the RBC when they become deoxygenated. It is this clump of hemoglobin that causes a cell to sickle. They have the capacity to carry just as much oxygen as normal hemoglobin molecules. The problem with RBCs that are sickled is that they tend to lyse pretty easily, resulting in an anemia. Someone mentioned reticulocytes, which are precursors to mature RBCs. The body reacts to the anmeia by releasing immature RBCs, aka reticulocytes. In times of severe stress many RBCs being sickling and they start to clump together in the microvasculature casuing a vasoclusive crisis which is usually painful and one of the main reasons that people with SCD seek medical attention. The WBC and platelet counts are ususally mildly elevated, even during non crisis times due to the body's attempt to correct the anemia.

Hope this helps.

[xselerate]

Is it too much to think about or am i just being geeky

If anything you should learn that everyone is geeky here... aren't questions like yours half the point of a place like this?

Good luck in medic school!

[als_medic_uk]

Yes, each sickle RBC carries less oxygen, because of its deformity but I'm almost certain it doesn't affect WBC content ( http://www.drspock.com/article/0,1510,5072,00.html )

Glad to hear you have graduated as an EMT, you seem to be making good progress, keep absorbing the information, however, both the white blood cell (WBC) count and the platelet count are increased due to amplified marrow activity, plagiaristic to chronic haemolytic anaemia. Hope you will remember these physiological motions.

Regards.

[AnthonyM83]

Glad to hear you have graduated as an EMT, you seem to be making good progress, keep absorbing the information, however, both the white blood cell (WBC) count and the platelet count are increased due to amplified marrow activity, plagiaristic to chronic haemolytic anaemia. Hope you will remember these physiological motions.

Regards.

Sorry. The page I read made me think that they were only amplified in response to other sicknesses that sickle cell person also has. Ill be more careful

PS: apostrophe key not working

[AnthonyM83]

Glad to hear you have graduated as an EMT, you seem to be making good progress, keep absorbing the information, however, both the white blood cell (WBC) count and the platelet count are increased due to amplified marrow activity, plagiaristic to chronic haemolytic anaemia. Hope you will remember these physiological motions.

Regards.

And just to clarify, that amplification of WBC in sickle cell happens just as a "side product" of the bone marrow producing more erythrocytes, rather than for a specific purpose?

[als_medic_uk]

Yes, however, in Haemolytic anaemia, the production of RBC's are insufficient and cause a crisis, a transfusion is normally needed.

Regards