Diagnosis
Several methods can detect the sickle cell shape of the red blood cells. The easiest way to do this is by observation: If a drop of blood is spread out on a glass slide and sealed against air, affected erythrocytes take on the sickle shape (called sickle cells or drepanocytes). So-called target-cells or shooting-disk cells can also be recognized in this form of anemia: they have a red condensed color in the center and generally indicate a loss of cell function.
This form can also occur in other anemias and is therefore not specific. The most accurate method is a chemical procedure with the complicated name of high-pressure liquid chromatography. This is able to separate different molecules and compare them with each other. In the process, the altered hemoglobin molecule HbS can be identified.
Occurrence
Sickle cell anemia occurs mainly in Africa and the eastern Mediterranean region. In Germany, it is practically non-existent, but if it does, it occurs in refugees or people with a migration background. In 2010 it was surveyed that there were about 1000-1500 sickle cell patients living in Germany, mainly from Turkey, Italy, Greece, North and Central Africa, the Middle East and India. The geographical limitation is probably due to a selection advantage due to malaria.
Frequency
Sickle cell anemia is the most common corpuscular (blood cell related) anemia worldwide, probably also because of the selection advantage. Depending on the level of development of the country, malaria can also be fatal. A record 1.8 million malaria deaths were estimated in 2004.
Special feature Malaria
For the first time in the 1940s, researchers discovered that many people had “different blood” in the areas where the severe form of malaria (Malaria tropcians) was found.Malaria is a parasitic disease transmitted by the Anopheles mosquito. The plasmodia (parasites) first attack the liver, then the red blood cells and continue to multiply in these. In people with sickle cell anaemia, the plasmodia in the erythrocytes do not multiply. More precise causes are not known to date. In this context, a person with sickle cell anemia can claim to be (partially) resistant to malaria.
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