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Diseases » Sickle Cell Anemia » Symptoms

Symptoms of Sickle Cell Anemia



Contents

List of symptoms of Sickle Cell Anemia:

The list of signs and symptoms mentioned in various sources for Sickle Cell Anemia includes the 61 symptoms listed below:

Note that Sickle Cell Anemia symptoms usually refers to various symptoms known to a patient, but the phrase Sickle Cell Anemia signs may refer to those signs only noticable by a doctor.

More ways to research these symptoms: To research other symptoms use the symptom center, or to research causes of more than one symptom in combination, try our multi-symptom search.

Research More About Sickle Cell Anemia

Do I have Sickle Cell Anemia?

Home Diagnostic Testing

Home medical tests related to Sickle Cell Anemia:

Wrongly Diagnosed with Sickle Cell Anemia?

The list of other diseases or medical conditions that may be on the differential diagnosis list of alternative diagnoses for Sickle Cell Anemia includes:

See the full list of 3 alternative diagnoses for Sickle Cell Anemia

More about symptoms of Sickle Cell Anemia:

More information about symptoms of Sickle Cell Anemia and related conditions:

Other Possible Causes of these Symptoms

Click on any of the symptoms below to see a full list of other causes including diseases, medical conditions, toxins, drug interactions, or drug side effect causes of that symptom.

Medical Books Online about Sickle Cell Anemia

Medical Books Excerpts Excerpts of published medical book chapters related to Sickle Cell Anemia are available from published medical books for more detailed information about Sickle Cell Anemia.

Medical Books Excerpts

ANEMIA

  • "Algorithmic Diagnosis of Symptoms and Signs"

FATIGUE

  • "Algorithmic Diagnosis of Symptoms and Signs"

Anemia

  • "In a Page: Signs and Symptoms"

Fatigue

  • "In a Page: Signs and Symptoms"

Anemia

  • "In A Page: Pediatric Signs and Symptoms"

Fatigue

  • "In A Page: Pediatric Signs and Symptoms"

Pallor

  • "In A Page: Pediatric Signs and Symptoms"

ANEMIA

  • "Differential Diagnosis in Primary Care"

PALLOR OF THE FACE, NAILS, OR CONJUNCTIVA

  • "Differential Diagnosis in Primary Care"

WEAKNESS AND FATIGUE, GENERALIZED

  • "Differential Diagnosis in Primary Care"

Fatigue

  • "Handbook of Signs & Symptoms (Third Edition)"

Pallor

  • "Handbook of Signs & Symptoms (Third Edition)"

Folic acid deficiency anemia

  • "Professional Guide to Diseases (Eighth Edition)"

Iron deficiency anemia

  • "Professional Guide to Diseases (Eighth Edition)"

Pernicious anemia

  • "Professional Guide to Diseases (Eighth Edition)"

Sideroblastic anemias

  • "Professional Guide to Diseases (Eighth Edition)"

Sickle cell anemia

  • "Professional Guide to Diseases (Eighth Edition)"

Sickle cell crisis

  • "Professional Guide to Diseases (Eighth Edition)"

Aplastic anemias

  • "Professional Guide to Diseases (Eighth Edition)"

Chronic fatigue syndrome

  • "Professional Guide to Diseases (Eighth Edition)"

Fatigue

  • "Professional Guide to Signs & Symptoms (Fifth Edition)"

Pallor

  • "Professional Guide to Signs & Symptoms (Fifth Edition)"

Anemia

  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter"

Fatigue

  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter"

Anemia

  • "Field Guide to Bedside Diagnosis"

Fatigue

  • "Field Guide to Bedside Diagnosis"

Folic acid deficiency anemia

  • "Handbook of Diseases"

Iron deficiency anemia

  • "Handbook of Diseases"

Pernicious anemia

  • "Handbook of Diseases"

Sideroblastic anemias

  • "Handbook of Diseases"

Sickle cell anemia

  • "Handbook of Diseases"

Aplastic and hypoplastic anemias

  • "Handbook of Diseases"

Chronic fatigue and immune dysfunction syndrome

  • "Handbook of Diseases"

Pallor

  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series"

Fatigue

  • "Signs & Symptoms: A 2-in-1 Reference for Nurses"

Pallor

  • "Signs & Symptoms: A 2-in-1 Reference for Nurses"

Fatigue

  • "The Diagnostic Approach to Symptoms and Signs in Pediatrics"

Pallor (Anemia)

  • "The Diagnostic Approach to Symptoms and Signs in Pediatrics"

Fatigue

  • "Nursing: Interpreting Signs and Symptoms"

Pallor

  • "Nursing: Interpreting Signs and Symptoms"

Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

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Patient Surveys for Sickle Cell Anemia

Symptoms of Sickle Cell Anemia: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the symptoms of Sickle Cell Anemia.


Folic acid deficiency anemia: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Folic acid deficiency anemia gradually produces clinical features characteristic of other megaloblastic anemias, without the neurologic manifestations: progressive fatigue, shortness of breath, palpitations, weakness, glossitis, nausea, anorexia, headache, fainting, irritability, forgetfulness, pallor, and slight jaundice. Folic acid deficiency anemia doesn’t cause neurologic impairment unless it’s associated with vitamin B12 deficiency, as in pernicious anemia.

READ BOOK EXCERPT ONLINE »

Iron deficiency anemia: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Because of the gradual progression of iron deficiency anemia, many patients are initially asymptomatic except for symptoms of any underlying condition. They tend not to seek medical treatment until anemia is severe. At advanced stages, decreased Hb levels and the consequent decrease in the blood’s oxygen-carrying capacity cause the patient to develop dyspnea on exertion, fatigue, listlessness, pallor, inability to concentrate, irritability, headache, and a susceptibility to infection. Decreased oxygen perfusion causes the heart to compensate with increased cardiac output and tachycardia.

In chronic iron deficiency anemia, nails become spoon-shaped and brittle, the mouth’s corners crack, the tongue turns smooth, and the patient complains of dysphagia or may develop pica. Associated neuromuscular effects include vasomotor disturbances, numbness and tingling of the extremities, and neuralgic pain.

READ BOOK EXCERPT ONLINE »

Pernicious anemia: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Characteristically, pernicious anemia has an insidious onset but eventually causes an unmistakable triad of symptoms: weakness, sore tongue, and numbness and tingling in the extremities. The lips, gums, and tongue appear markedly bloodless. Hemolysis-induced hyperbilirubinemia may cause faintly jaundiced sclera and pale to bright yellow skin. In addition, the patient may become highly susceptible to infection, especially of the genitourinary tract.

Other systemic symptoms of pernicious anemia include the following:

❑ GI: Gastric mucosal atrophy and decreased hydrochloric acid production disturb digestion and lead to nausea, vomiting, anorexia, weight loss, flatulence, diarrhea, and constipation. Gingival bleeding and tongue inflammation may hinder eating and intensify anorexia.

❑ Central nervous system (CNS): Demyelination caused by vitamin B12 deficiency initially affects the peripheral nerves but gradually extends to the spinal cord. Consequently, the neurologic effects of pernicious anemia may include neuritis; weakness in extremities; peripheral numbness and paresthesia; disturbed position sense; lack of coordination; ataxia; impaired fine finger movement; positive Babinski’s and Romberg’s signs; light-headedness; altered vision (diplopia and blurred vision), taste, and hearing (tinnitus); optic muscle atrophy; loss of bowel and bladder control; and, in males, impotence. Its effects on the nervous system may also produce irritability, poor memory, headache, depression, and delirium. Although some of these symptoms are temporary, irreversible CNS changes may have occurred before treatment.

❑ Cardiovascular: Increasingly fragile cell membranes induce widespread destruction of RBCs, resulting in low Hb levels. The impaired oxygen-carrying capacity of the blood secondary to lowered Hb leads to weakness, fatigue, and light-headedness. Compensatory increased cardiac output results in palpitations, wide pulse pressure, dyspnea, orthopnea, tachycardia, premature beats and, eventually, heart failure.

❑ Musculoskeletal: Scissors gait can also occur as a late sign of untreated anemia.

READ BOOK EXCERPT ONLINE »

Sideroblastic anemias: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Sideroblastic anemias usually produce nonspecific clinical effects, which may exist for several years before being identified. Such effects include anorexia, fatigue, weakness, dizziness, pale skin and mucous membranes and, occasionally, enlarged lymph nodes. Heart and liver failure may develop due to excessive iron accumulation in these organs, causing dyspnea, exertional angina, slight jaundice, and hepatosplenomegaly. Hereditary sideroblastic anemia is associated with increased GI absorption of iron, causing signs of hemosiderosis. Additional symptoms in secondary sideroblastic anemia depend upon the underlying cause.

READ BOOK EXCERPT ONLINE »

Sickle cell anemia: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Characteristically, sickle cell anemia produces tachycardia, cardiomegaly, systolic and diastolic murmurs, pulmonary infarctions (which may result in cor pulmonale), chronic fatigue, unexplained dyspnea or dyspnea on exertion, hepatomegaly, jaundice, pallor, joint swelling, aching bones, chest pains, ischemic leg ulcers (especially around the ankles), and increased susceptibility to infection. Such symptoms usually don't develop until after age 6 months because large amounts of fetal Hb protect infants for the first few months after birth. Low socioeconomic status and related problems, such as poor nutrition and education, may delay diagnosis and supportive treatment.

Infection, stress, dehydration, and conditions that provoke hypoxia — strenuous exercise, high altitude, unpressurized aircraft, cold, and vasoconstrictive drugs —may all provoke periodic crises. A painful crisis (vasoocclusive crisis, infarctive crisis), the most common crisis and the hallmark of the disease, usually appears periodically after age 5. It results from blood vessel obstruction by rigid, tangled sickle cells, which causes tissue anoxia and possible necrosis. This type of crisis is characterized by severe abdominal, thoracic, muscular, or bone pain and possibly worsening jaundice, dark urine, and a low-grade fever.

Autosplenectomy, in which splenic damage and scarring is so extensive that the spleen shrinks and becomes impalpable, occurs in patients with long-term disease. This can lead to increased susceptibility to Streptococcus pneumoniae sepsis, which can be fatal without prompt treatment. Infection may develop after the crisis subsides (in 4 days to several weeks), so watch for lethargy, sleepiness, fever, or apathy.

An aplastic crisis (megaloblastic crisis) results from bone marrow depression and is associated with infection, usually viral. It's characterized by pallor, lethargy, sleepiness, dyspnea, possible coma, markedly decreased bone marrow activity, and RBC hemolysis.

In infants between ages 8 months and 2 years, an acute sequestration crisis may cause sudden massive entrapment of RBCs in the spleen and liver. This rare crisis causes lethargy and pallor and, if untreated, commonly progresses to hypovolemic shock and death.

A hemolytic crisis is quite rare and usually occurs in patients who also have glucose-6-phosphate dehydrogenase deficiency. It probably results from complications of sickle cell anemia, such as infection, rather than from the disorder itself. Hemolytic crisis causes liver congestion and hepatomegaly as a result of degenerative changes. It worsens chronic jaundice, although increased jaundice doesn't always point to a hemolytic crisis.

Suspect any of these crises in a sickle cell anemia patient with pale lips, tongue, palms, or nail beds; lethargy; listlessness; sleepiness with difficulty awakening; irritability; severe pain; a fever over 104° F (40° C); or a fever of 100° F (37.8° C) that persists for 2 days.

Sickle cell anemia also causes long-term complications. Typically, the child is small for his age and has delayed puberty. (However, fertility isn't impaired.) If he reaches adulthood, his body build tends to be spiderlike — narrow shoulders and hips, long extremities, curved spine, barrel chest, and elongated skull. An adult usually has complications from organ infarction, such as retinopathy and nephropathy. Premature death commonly results from infection or from repeated occlusion of small blood vessels and consequent infarction or necrosis of major organs (such as cerebral blood vessel occlusion causing stroke).

READ BOOK EXCERPT ONLINE »

Sickle cell crisis: Signs and Symptoms
(Professional Guide to Diseases (Eighth Edition))

Pale lips, tongue, nail beds, and palms; lethargy; irritability; severe pain; temperature above 104° F (40° C)

READ BOOK EXCERPT ONLINE »

Aplastic anemias: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Clinical features of aplastic anemias vary with the severity of pancytopenia but develop insidiously in many cases. Anemic symptoms include progressive weakness and fatigue, shortness of breath, headache, pallor and, ultimately, tachycardia and heart failure. Thrombocytopenia leads to ecchymosis, petechiae, and hemorrhage, especially from the mucous membranes (nose, gums, rectum, and vagina) or into the retina or central nervous system. Neutropenia may lead to infection (fever, oral and rectal ulcers, and sore throat) but without characteristic inflammation.

READ BOOK EXCERPT ONLINE »

Chronic fatigue syndrome: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

CFS has specific symptoms and signs, based on the exclusion of other possible causes. Its characteristic symptom is prolonged, often overwhelming fatigue that’s commonly associated with a varying complex of other symptoms that are similar to those of many infections, including myalgia and cephalgia. It may develop within a few hours and can last for 6 months or more. Fatigue isn’t relieved by rest and is severe enough to restrict activities of daily living by at least 50%. To aid in disease identification, the Centers for Disease Control and Prevention (CDC) uses a “working case definition” to group symptoms and severity.

READ BOOK EXCERPT ONLINE »

Folic acid deficiency anemia: Signs and symptoms
(Handbook of Diseases)

Folic acid deficiency anemia gradually produces clinical features that are characteristic of other megaloblastic anemias without the neurologic manifestations. These include progressive fatigue, dyspnea, palpitations, weakness, glossitis, nausea, anorexia, headache, fainting, irritability, forgetfulness, pallor, and slight jaundice.

Folic acid deficiency anemia doesn’t cause neurologic impairment unless it’s associated with vitamin B12 deficiency, as in pernicious anemia.

READ BOOK EXCERPT ONLINE »

Iron deficiency anemia: Signs and symptoms
(Handbook of Diseases)

Because of the gradual progression of iron deficiency anemia, many patients are initially asymptomatic. They tend not to seek medical treatment until anemia is severe.

At advanced stages, a decreased Hb level and the consequent decrease in the blood’s oxygen-carrying capacity cause the patient to develop exertional dyspnea, fatigue, listlessness, pallor, inability to concentrate, irritability, headache, and a susceptibility to infection. Decreased oxygen perfusion causes the heart to compensate with increased cardiac output and tachycardia.

With chronic iron deficiency anemia, nails become spoon shaped and brittle, the corners of the mouth crack, the tongue turns smooth, and the patient complains of dysphagia or may develop pica. Associated neuromuscular effects include vasomotor disturbances, numbness and tingling of the extremities, and neuralgic pain.

READ BOOK EXCERPT ONLINE »

Pernicious anemia: Signs and symptoms
(Handbook of Diseases)

Characteristically, pernicious anemia has an insidious onset but eventually causes an unmistakable triad of symptoms: weakness, sore tongue, and numbness and tingling in the extremities. The lips, gums, and tongue appear markedly bloodless. Hemolysis-induced hyperbilirubinemia may cause faintly jaundiced sclera and pale to bright yellow skin. The patient may also become highly susceptible to infection, especially of the genitourinary tract.

GI signs and symptoms

Gastric mucosal atrophy and decreased hydrochloric acid production disturb digestion and lead to nausea, vomiting, anorexia, weight loss, flatulence, diarrhea, and constipation. Gingival bleeding and tongue inflammation may hinder eating and intensify anorexia.

Central nervous system signs and symptoms

Nerve demyelination caused by vitamin B12 deficiency initially affects the peripheral nerves but gradually extends to the spinal cord. Consequently, the neurologic effects of pernicious anemia include neuritis, weakness in the extremities, peripheral numbness and paresthesia, disturbed position sense, lack of coordination, ataxia, impaired fine finger movement, positive Babinski’s and Romberg’s signs, light-headedness, optic muscle atrophy, loss of bowel and bladder control, impotence (in males), and altered vision (diplopia, blurred vision), taste, and hearing (tinnitus).

The effects of pernicious anemia on the nervous system may also produce irritability, poor memory, headache, depression, and delirium. Although some of these symptoms are temporary, irreversible central nervous system changes may have occurred before treatment is initiated.

Cardiovascular signs and symptoms

Increasingly fragile cell membranes induce widespread destruction of RBCs, resulting in low hemoglobin (Hb) levels. The impaired oxygen-carrying capacity of the blood secondary to lowered Hb leads to weakness, fatigue, and light-headedness. Compensatory increased cardiac output results in palpitations, wide pulse pressure, dyspnea, orthopnea, tachycardia, premature beats and, eventually, heart failure.

READ BOOK EXCERPT ONLINE »

Sideroblastic anemias: Signs and symptoms
(Handbook of Diseases)

Sideroblastic anemias usually produce nonspecific clinical effects, which may exist for several years before being identified. Such effects include anorexia, fatigue, weakness, dizziness, pale skin and mucous membranes and, occasionally, enlarged lymph nodes.

Heart and liver failure may develop from excessive iron accumulation in these organs, causing dyspnea, exertional angina, slight jaundice, and hepatosplenomegaly. Hereditary sideroblastic anemia is associated with increased GI absorption of iron, causing signs of hemosiderosis. Additional symptoms in secondary sideroblastic anemia depend on the underlying cause.

READ BOOK EXCERPT ONLINE »

Sickle cell anemia: Signs and symptoms
(Handbook of Diseases)

Characteristically, sickle cell anemia produces tachycardia, cardiomegaly, systolic and diastolic murmurs, pulmonary infarctions (which may result in cor pulmonale), chronic fatigue, unexplained dyspnea or dyspnea on exertion, hepatomegaly, jaundice, pallor, joint swelling, aching bones, chest pains, ischemic leg ulcers (especially around the ankles), and increased susceptibility to infection.

Such symptoms usually don’t develop until after age 6 months, because large amounts of fetal Hb protect infants for the first few months after birth. Low socioeconomic status and related problems, such as poor nutrition and education, may delay diagnosis and supportive treatment.

Infection, stress, dehydration, and conditions that provoke hypoxia —  strenuous exercise, high altitude, unpressurized aircraft, cold, and vasoconstrictive drugs — may all provoke periodic crisis. Four types of crises can occur: painful, aplastic, acute sequestration, or hemolytic.

Painful crisis

Also called a vaso-occlusive crisis or infarctive crisis, painful crisis is the most common crisis and the hallmark of this disease. It usually appears periodically after age 5.

A painful crisis results from blood vessel obstruction by rigid, tangled sickle cells, which causes tissue anoxia and possible necrosis. It’s characterized by severe abdominal, thoracic, muscular, or bone pain and, possibly, increased jaundice, dark urine, or a low-grade fever.

UNDER STUDY:  In pediatric patients with vaso-occlusive crisis, 1-arginine, a precursor to nitric oxide, has been found to be diminished. In adults, it has been significantly diminished in 50% of patients administered to the emergency department with vaso-occlusive crisis.

Autosplenectomy, in which splenic damage and scarring is so extensive that the spleen shrinks and becomes impalpable, occurs in patients with long-term disease. This can lead to increased susceptibility to Streptococcus pneumoniae sepsis, which can be fatal without prompt treatment.

After the crisis subsides (in 4 days to several weeks), infection may develop, causing such signs as lethargy, sleepiness, fever, and apathy.

Aplastic crisis

Also called megaloblastic crisis, aplastic crisis results from bone marrow depression and is associated with infection, usually viral. It’s characterized by pallor, lethargy, sleepiness, dyspnea, possible coma, markedly decreased bone marrow activity, and RBC hemolysis.

Acute sequestration crisis

In infants between 8 months and 2 years old, an acute sequestration crisis may cause sudden massive entrapment of RBCs in the spleen and liver. This rare crisis causes lethargy and pallor; if untreated, it commonly progresses to hypovolemic shock and death.

Hemolytic crisis

Quite rare, hemolytic crisis usually occurs in patients who have glucose-6-phosphate dehydrogenase deficiency with sickle cell anemia. It probably results from complications of sickle cell anemia, such as infection, rather than from the disorder itself.

Hemolytic crisis causes liver congestion and hepatomegaly as a result of degenerative changes. It worsens chronic jaundice, although increased jaundice doesn’t always point to a hemolytic crisis.

Indicators of crisis

Suspect any of these crises in a sickle cell anemia patient with pale lips, tongue, palms, or nail beds; lethargy; listlessness; sleepiness, with difficulty awakening; irritability; severe pain; temperature over 104° F (40° C); or a fever of 100° F (37.8° C) that persists for 2 days.

Long-term complications

Sickle cell anemia also causes long-term complications. Typically, such a child is small for his age, and puberty is delayed. (However, fertility isn’t impaired). If he reaches adulthood, his body build tends to be spiderlike — narrow shoulders and hips, long extremities, curved spine, barrel chest, and elongated skull.

An adult usually has complications with organ infarction, such as retinopathy and nephropathy. Premature death commonly results from infection or repeated occlusion of small blood vessels and consequent infarction or necrosis of major organs. For example, cerebral blood vessel occlusion causes cerebrovascular accident.

READ BOOK EXCERPT ONLINE »

Aplastic and hypoplastic anemias: Signs and symptoms
(Handbook of Diseases)

Signs and symptoms of aplastic anemias vary with the severity of pancytopenia but usually develop insidiously. These include progressive weakness and fatigue, shortness of breath, headache, pallor and, ultimately, tachycardia and heart failure. Thrombocytopenia leads to ecchymosis, petechiae, and hemorrhage, especially from the mucous membranes (nose, gums, rectum, and vagina) or into the retina or central nervous system. Neutropenia may lead to infection (with fever, oral and rectal ulcers, and sore throat) but without characteristic inflammation.

READ BOOK EXCERPT ONLINE »

Chronic fatigue and immune dysfunction syndrome: Signs and symptoms
(Handbook of Diseases)

The characteristic symptom of CFIDS is prolonged, often overwhelming fatigue that’s commonly associated with a varying complex of other symptoms. To aid identification of the disease, the Centers for Disease Control and Prevention (CDC) uses a “working case definition” to group symptoms and severity. (See CDC criteria for diagnosing CFIDS.)

READ BOOK EXCERPT ONLINE »

Article Excerpts About Symptoms of Sickle Cell Anemia:

Genes and Disease by the National Center for Biotechnology (Excerpt)

SCA is characterized by episodes of pain, chronic hemolytic anemia and severe infections, usually beginning in early childhood. (Source: Genes and Disease by the National Center for Biotechnology)

NHLBI, Fact Sheet Multicenter Study of Hydroxyurea for Sickle Cell Anemia: NHLBI (Excerpt)

A painful crisis is a sudden attack of pain, which may be mild or extremely severe, often occurring in bones and joints in adults. For this study, which was limited to patients with moderately severe disease (at least 3 attacks/year), a crisis was a visit to a medical facility for pain not due to another disease, lasting at least 4 hours, and treated with injections of a narcotic pain-killer. (Source: excerpt from NHLBI, Fact Sheet Multicenter Study of Hydroxyurea for Sickle Cell Anemia: NHLBI)

Sickle Cell Anemia as a Cause of Symptoms or Medical Conditions

When considering symptoms of Sickle Cell Anemia, it is also important to consider Sickle Cell Anemia as a possible cause of other medical conditions. The Disease Database lists the following medical conditions that Sickle Cell Anemia may cause:

- (Source - Diseases Database)

Medical articles and books on symptoms:

These general reference articles may be of interest in relation to medical signs and symptoms of disease in general:

Full list of premium articles on symptoms and diagnosis

About signs and symptoms of Sickle Cell Anemia:

The symptom information on this page attempts to provide a list of some possible signs and symptoms of Sickle Cell Anemia. This signs and symptoms information for Sickle Cell Anemia has been gathered from various sources, may not be fully accurate, and may not be the full list of Sickle Cell Anemia signs or Sickle Cell Anemia symptoms. Furthermore, signs and symptoms of Sickle Cell Anemia may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Sickle Cell Anemia symptoms.


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