What finding is typically seen on a peripheral blood smear in a patient with sickle cell disease experiencing a pain crisis?

What finding is typically seen on a peripheral blood smear in a patient with sickle cell disease experiencing a pain crisis?

• A. Sickle-shaped red blood cells
• B. Target cells
• C. Howell-Jolly bodies
• D. Burr cells

Answer: (A)

In a pain crisis from sickle cell disease, the main feature on a peripheral smear is sickled red blood cells. These are crescent- or sickle-shaped and arise when hemoglobin S polymerizes in the deoxygenated state, making the cells rigid and distorted. This shape change underlies the vaso-occlusive pain by obstructing small vessels and causing ischemia in tissues. Other findings like target cells, Howell-Jolly bodies, or burr cells can appear in various conditions or with chronic spleen changes in sickle cell patients, but they are not the characteristic acute sign during a pain crisis. The presence of visibly sickled cells best reflects the pathophysiology driving the crisis.

In a pain crisis from sickle cell disease, the main feature on a peripheral smear is sickled red blood cells. These are crescent- or sickle-shaped and arise when hemoglobin S polymerizes in the deoxygenated state, making the cells rigid and distorted. This shape change underlies the vaso-occlusive pain by obstructing small vessels and causing ischemia in tissues.

Other findings like target cells, Howell-Jolly bodies, or burr cells can appear in various conditions or with chronic spleen changes in sickle cell patients, but they are not the characteristic acute sign during a pain crisis. The presence of visibly sickled cells best reflects the pathophysiology driving the crisis.