Death due to microvascular occlusion in sickle-cell trait following physical exertion

D. P. Wirthwein, S. D. Spotswood, J. J. Barnard, J. A. Prahlow

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

The heterozygous condition characterized by the presence of hemoglobin AS (sickle-cell trait) occurs in approximately 8% of the American black population. Unlike the homozygous state (sickle-cell disease), sickle-cell trait is not widely recognized as a cause of life-threatening illness or death despite over 30 case reports describing fatal or serious complications of exercise in young black males with this condition. These reports identify heat stress, dehydration, viral illness, and poor physical conditioning as factors which may contribute to exertional rhabdomyolysis and sudden death, suggesting multifactorial etiology. However, since sickling is known to occur postmortem, it remains controversial as to whether the pathogenesis of these exercise related deaths involves microvascular obstruction by sickled erythrocytes. We describe three young black individuals with no significant past medical history who died following physical exertion. In all three cases, postmortem hemoglobin electrophoresis demonstrated hemoglobin AS. In none of the cases was the body temperature found to be elevated. These cases serve to remind the forensic community that, in the proper setting, sickle-cell trait must be viewed as a potentially fatal disorder.

Original languageEnglish (US)
Pages (from-to)399-401
Number of pages3
JournalJournal of Forensic Sciences
Volume46
Issue number2
StatePublished - 2001

Fingerprint

Sickle Cell Trait
Physical Exertion
death
illness
Rhabdomyolysis
Sickle Cell Anemia
Sudden Death
conditioning
etiology
Body Temperature
Dehydration
heat
Electrophoresis
Hemoglobins
Hot Temperature
Erythrocytes
Disease
cause
Population
community

Keywords

  • Death
  • Exercise
  • Forensic pathology
  • Forensic science
  • Hemoglobin
  • Sickle-cell trait
  • Sudden death

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Law

Cite this

Death due to microvascular occlusion in sickle-cell trait following physical exertion. / Wirthwein, D. P.; Spotswood, S. D.; Barnard, J. J.; Prahlow, J. A.

In: Journal of Forensic Sciences, Vol. 46, No. 2, 2001, p. 399-401.

Research output: Contribution to journalArticle

Wirthwein, D. P. ; Spotswood, S. D. ; Barnard, J. J. ; Prahlow, J. A. / Death due to microvascular occlusion in sickle-cell trait following physical exertion. In: Journal of Forensic Sciences. 2001 ; Vol. 46, No. 2. pp. 399-401.
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