Understand The Risks Of Sickle Cell

It is important to always talk to your doctor about the risks of Sickle Cell. Being aware of your body and any changes that occur can help you stay ahead of severe complications that can occur with Sickle Cell. Always talk to your doctor about changes you notice in your body and any worries you have. The complications of Sickle Cell can be scary, painful, and dangerous. Understanding them is the first step to monitoring your health and taking action. For guidance on navigating the complications, see how to manage.

Some of the most common problems that arise with Sickle Cell include:


Pain is a common complication of Sickle Cell. You might have pain in your back, knees, legs, arms, chest or stomach. The pain can be throbbing, sharp, dull or stabbing. How often and how bad the pain gets varies a lot from person to person. You may experience less severe (or chronic) pain on a day-to-day basis. You may also experience more severe (or acute) pain that begins suddenly and lasts for several hours, and is often called a pain crisis. A pain crisis happens when sickled red blood cells block small blood vessels that carry blood to your bones and organs. Possible pain triggers include:

  • Stress
  • Not being sufficiently hydrated
  • Illness
  • Changes in temperature, for example if you go from a warm house into a cold winter day and you haven’t bundled up, or if you swim in cold water
  • Being at high altitudes

Acute Chest Syndrome:

Blockage of the flow of blood to the lungs can cause Acute Chest Syndrome (ACS). When this happens, areas of lung tissue are damaged and cannot exchange oxygen properly. It can be life-threatening and should be treated in a hospital. ACS often starts a few days after a painful crisis begins. Symptoms may include:

  • Chest pain
  • Cough
  • Fever
  • Rapid breathing
  • Shortness of breath


A stroke occurs when blood flow is blocked to a part of the brain. When this happens, brain cells can be damaged or can die. In Sickle Cell, the term clinical stroke is used to mean that a person shows outward signs that something is wrong. The symptoms depend upon what part of the brain is affected. Symptoms of stroke may include:

  • Loss of balance
  • Severe headache
  • Trouble speaking, walking, or understanding
  • Weakness of an arm or leg on one side of the body

Silent Stroke and Thinking Problems:

Silent brain injury is damage to the brain without showing outward signs of stroke. Brain imaging and tests of thinking, or cognitive studies, have shown that children and adults with Sickle Cell often have signs of silent brain injury, also called silent stroke.

Heart Problems:

People with Sickle Cell can have problems with blood vessels in the heart and with heart function. The heart can become larger than normal. People who have Sickle Cell can also develop a type of high blood pressure known as pulmonary hypertension, which occurs in the blood vessels of the lungs and the heart. This can cause shortness of breath and fatigue. People with Sickle Cell who have received frequent blood transfusions may also have heart damage from iron overload.

Kidney Problems:

The kidneys are sensitive to the effects of red blood cell sickling. Sickle Cell can cause the kidneys to have trouble making the urine as concentrated as it should be. This may lead to a need to urinate often and to have bedwetting or uncontrolled urination during the night. This is called enuresis, and often starts in childhood. You still need to drink lots of water. Staying hydrated does not cause uncontrolled urination. The way your kidneys make urine does. Other problems may include blood in the urine and protein loss in the urine, which may ultimately progress to chronic kidney disease and kidney failure.


Males with Sickle Cell can have unwanted and painful erections that last a long time. This condition is called priapism. Priapism happens when blood flow out of the erect penis is blocked by sickled cells. If it goes on for a long period of time without intervention, priapism can cause permanent damage to the penis and lead to impotence. If priapism lasts for more than four hours, emergency medical care should be sought to avoid complications.


When red blood cells get destroyed, they release hemoglobin into the bloodstream. Hemoglobin gets broken down into a substance called bilirubin. Bilirubin can form stones that get stuck in the gallbladder, which is called cholelithiasis. The gallbladder is a small, sac-shaped organ beneath the liver that helps with digestion. Many people with Sickle Cell have gallbladder problems. Gallstones can also lead to gallbladder infection, called cholecystitis. Common signs and symptoms of gallbladder include:

  • Nausea
  • Pain in the right upper belly (especially after eating fatty foods)
  • Vomiting

Liver Complications:

When sickled cells block blood vessels in the liver, it can cause Sickle Cell intrahepatic cholestasis, which is an uncommon but severe type of liver damage. This blockage prevents enough oxygen from reaching liver tissue. These episodes are usually sudden and can happen again. Children often recover, but some adults may have chronic problems that lead to liver failure. People with Sickle Cell who have received frequent blood transfusions may develop liver damage from iron overload.

Complications in Pregnancy:

Pregnancies in women who have Sickle Cell can be risky for both the mother and the baby.

During pregnancy, women may have medical complications that include:

  • Blood clots
  • High blood pressure
  • Increased pain episodes
  • Infections

They also are at higher risk for:

  • Miscarriages
  • Premature births
  • Small-for-date or underweight babies