When do patients start to manifest symptoms of sickle cell disease?
Dr. Krishnamurti: Because in the United States every baby born is screened for sickle cell disease, we’re not waiting to find out later when it’s presenting. I typically see babies with sickle cell disease when they’re about a week old, much before they might actually develop any symptoms. The earliest symptom might be in infancy when they might get painful swelling of their hands and feet. There’s also a big danger for a child with sickle cell disease – one of the first organs to be affected is the spleen. The spleen is the organ that lives under the left side of your rib cage and it’s important for fighting infections when you’re too young to have built a repertoire of antibodies. It’s got a lot of blood vessels going through it, so the sickle red cells obstruct the blood flow and the spleen stops working, sometimes after the first six months of life. That puts this young child at a huge risk for infections, and by some particular organisms called pneumococcus – it’s a kind of bacter
