Complications & Damage

Complications & Damage

Understand the Risks of Sickle Cell

Talk with your healthcare provider about the risks of sickle cell. It’s not easy, but it’s important to know about. Talk about changes you notice in your body and any concerns you have. The problems of sickle cell can be scary, painful and dangerous. Understanding them is the first step to being proactive in your health and taking action. In addition to understanding the complications, you can also learn how to manage the experiences you might face.

Some of the most common problems that come with sickle cell include:


Pain is a common problem with sickle cell. You should talk to your doctor about any pain you’re having. 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 from person to person. You may have pain that’s just always there but doesn’t hurt as badly. You may also have severe pain that starts suddenly and lasts for several hours. That’s called a pain episode, or a pain crisis. A pain crisis happens when sickled red blood cells block blood vessels that carry blood to your bones and organs. Possible pain triggers include:

  • Stress
  • Not drinking enough fluids
  • Illness
  • Changes in temperature
  • Being at high altitudes (like in the mountains)

Acute Chest Syndrome

Blockage of blood flow to the lungs can cause acute chest syndrome (ACS). When this happens, areas of lung tissue are damaged and can’t provide oxygen. It can be life-threatening and should be treated in a hospital. ACS often starts a few days after a pain crisis starts. Symptoms may include:

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

Talk to your doctor if you experience these symptoms.


A stroke happens when blood flow is blocked to a part of the brain. When this happens, brain cells can be damaged or can die. The symptoms depend on 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

Talk to your doctor if you experience these symptoms.

Silent Stroke or Learning Disabilities

Silent brain injury is damage to the brain with no outward signs of stroke. Brain imaging and tests of thinking have shown that children and adults with sickle cell often have signs of silent brain injury, also called silent stroke.

Be sure to talk to your doctor if you think you have experienced a silent stroke or experience learning difficulties.

Heart Problems

People with sickle cell can have problems with blood vessels in the heart and their heart can become larger than normal. They can also have a type of high blood pressure known as pulmonary hypertension, which happens in the blood vessels of the lungs and heart. Pulmonary hypertension can cause shortness of breath and fatigue. People with sickle cell who have had a lot of blood transfusions may also have heart damage because they’ve received too much iron.

Talk to your doctor if you experience these symptoms or if you are concerned about blood transfusions.

Kidney Problems

Sickled red blood cells are hard on the kidneys. People with sickle cell can have:

  • Urine that is not as concentrated as it should be
  • Frequent urinating
  • Bedwetting
  • Blood in the urine
  • Protein in the urine

It’s always important to drink plenty of water. Talk with your healthcare provider about any trouble that you’re having with urination.


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 time without medical help, priapism can cause permanent damage to the penis and lead to impotence. Get medical care if priapism lasts for more than 4 hours.


When red blood cells die, they release hemoglobin into the bloodstream. Hemoglobin breaks down into a substance called bilirubin. Bilirubin can form stones that get stuck in the gallbladder. 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. Symptoms of gallbladder problems include:

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

Talk to your doctor if you experience these symptoms.

Liver Complications

When sickled cells block blood vessels in the liver, it can prevent oxygen from reaching liver tissue. These episodes are usually sudden and can happen repeatedly. Children often recover, but some adults may have ongoing problems that lead to liver failure. People with sickle cell who have received frequent blood transfusions may develop liver damage from iron overload.

Talk to your doctor if you think you may have liver complications.

Complications In Pregnancy

Pregnancies in women with sickle cell can be risky for both mother and baby.

During pregnancy, women may have medical problems 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