Patient: Hello, I am a carrier of sickle cell trait. My father passed it on to me over his Italian background. I am very concerned with my medical condition, because I want to join the United States Air Force. The job I would love to do has to be around a high altitude atmosphere. I will have to go airborne for tech school and also be inside an unpressurized aircraft for most likely hours. They do have oxygen masks on board, because everyone is not capable of breathing in low oxygen rates. I spoke with my doctor about my concerns, and have an appointment with a hemotologist next week. Unfortunetly I can’t wait any longer with the correct answer. I am absolutly in love with this job and I will give anything to start the career right away. Is there a chance I would not have any symptoms around the high altitude? If my parents never told me I had Sickle Cell Trait, I would never of known I had the trait. I excercise regularly and havent had any signs of dehydration or any of the symptoms. Please respond, I’m desperate for answers.
Doctor: Sickle cell disease is an autosomal recessive disease. If you are positive for sickle cell trait, then you only have one abnormal allele of the sickle cell trait. Sickle cell trait is generally a benign condition. However, in some people, having the sickle cell trait can have some rare complications including: pulmonary venous thromboembolism, mild strokes, poor urinary concentrating ability, increased incidence of renal carcinoma, splenic infarcts at high altitude. This is due to the red blood cell adopting a sickle cell shape under stress conditions and blocking arteries leading to these complications. Even though you exercise regularly and have not had any symptoms previously, this does not mean that these complications would not occur if your body were under stress. Referral to a haematologist is appropriate in your position as you may need to pass an official medical examination to enter into the US Air Force, and a Haematologist can provide further information in your particular case.