The various factors which cause or influence the phenomenon of sickling red cells are still poorly understood. This peculiar behavior of certain red blood corpuscles seems to be a racial characteristic, confined exclusively to the Negro, although a few cases of sickle cell anemia in white persons have been reported.1 From what is so far known, one must assume that sickling will only occur in the presence of a fundamental alteration in the physicochemical structure of the erythrocyte, since normal cells cannot be induced to undergo such a change in shape. This constitutional structural defect is already demonstrable in the hemoglobincontaining erythroblast.2
Hahn and Gillespie3 made the significant discovery that distortion of the susceptible corpuscles into sickle cells will only take place if the hemoglobin contained in the cells is in the reduced state. Presence of oxyhemoglobin or carbon monoxide hemoglobin prevents the sickle cell phenomenon. If
SINGER K, ROBIN S. RAPID TEST FOR THE DEMONSTRATION OF SICKLE CELLS AND ITS CLINICAL SIGNIFICANCE. JAMA. 1948;136(16):1021–1025. doi:10.1001/jama.1948.02890330011003
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