Four patients presenting unusual manifestations of sickle cell anemia were studied. Clinical variants were age, habitus, and pregnancy. In some cases, these features were so atypical as to suggest disease entities other than sickle cell anemia and obscure the diagnosis. The recognition of a wider clinical spectrum for occasional patients with this disease seems justified.
Richard C. Gause, Gerald N. Loomus, Arnold Nedelman, George O. Clifford. Atypical Sickle Cell Anemia. JAMA. 1963;186(7):624–626. doi:10.1001/jama.1963.03710070026005