A child suspected of having sickle cell disease is seen in a clinic, and laboratory studies are performed. A nurse checks the lab results, knowing which of the following would be increased in this disease?
A. Platelet count
B. Hematocrit level
C. Reticulocyte count
D. Hemoglobin level
Correct Answer: C. Reticulocyte count
A diagnosis is established based on a complete blood count, examination for sickled red blood cells in the peripheral smear, and hemoglobin electrophoresis. Increased reticulocyte counts occur in children with sickle cell disease because the lifespan of their sickled red blood cells is shortened. For most people, the number is very low because most reticulocytes stay in the bone marrow. If the child has sickle cell disease, she may have a higher reticulocyte count. This is because the child’s body has to make more red blood cells due to anemia.
Option A: Platelets are blood cells that help stop bleeding by making the blood clot. A normal platelet count is 150,000 to 400,000/mm3. If the child has a low platelet count, she may bruise or bleed more easily. Normally, sickle cell disease does not cause low platelet levels.
Option B: People with sickle cell disease have lower hemoglobin levels, usually between 6–11 g/dL. The exact level may be different depending on the type of sickle cell disease and the person. It is important to know the child’s usual hemoglobin level. Blood tests done over a period of time will tell the doctor what is normal for your child.
Option D: Laboratory studies will show decreased hemoglobin. The main purpose of red blood cells is to deliver oxygen to the body. The part of the blood that carries oxygen is called hemoglobin. People with sickle cell disease have abnormal hemoglobin, called sickle hemoglobin or hemoglobin S. If your child has sickle cell disease, her red blood cells do not last as long because the sickle hemoglobin damages them.
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