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To the Editor.—
I agree with everything in the article of Helzlsouer et al entitled "Severe Metabolic Complications in a Cross-Country Runner With Sickle Cell Trait" (1983;249:777) except the last sentence in the "Comment" section, which I consider not nearly strong enough, stating that "persons who have demonstrated problems after exertion, as our patient did on two separate occasions, should limit these activities." "Persons" are, of course, in the context of the article, blacks with sickle cell trait. In the first place, all blacks should be informed whether they have either homozygous or heterozygous hemoglobin S blood, the latter presenting sickle cell trait (about 8% of the population, or 2 1/2 million persons in the United States). Such knowledge is obtainable through adequate mass screening, to which many blacks are opposed for reasons that are not valid. As has been correctly pointed out in the article, the overall mortality of
Lowbeer L. Complications of Sickle Cell Trait. JAMA. 1983;250(3):360–361. doi:10.1001/jama.1983.03340030022016
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