Cocaine Use and Sickle Cell Trait

A case report links cocaine usage to sickle cell trait and states that cocaine may cause those with the sickle cell trait to exhibit symptoms experienced by those with sickle cell anemia.  Sickle cell is a mutation in an amino acid in a hemoglobin gene.  Sickle cell trait is the heterozygous version of this mutation, and is very common in the African American population. Sickle cell anemia is the homozygous version of the mutation, and though it is less common, the symptoms are always seen in those with sickle cell anemia.  Symptoms can be seen in those with the trait, though it is a rare occurrence.  A woman with sickle cell trait was emitted to an emergency department with abdominal pain.  She started feeling better then pain began increasing and needed breathing support.  While operating, surgeons found that her colon was not receiving enough oxygen , her spleen tissue was dead, and the cells of the surrounding layer of the abdomen had died.  Organ failure occurred after the operation and the woman passed away.  Pathology showed that red blood cells had sickled throughout the omentum, spleen, colon, and terminal ileum, and no bacteria and fungi were detected.  It was known that the woman had used cocaine.  Catecholamines circulate within the bloodstream, and an increase in the circulating concentration is associated with cocaine use.  These higher concentrations can ultimately cause less oxygen to get to the desired location, which then causes red blood cells to sickle and ultimately have damaging effects on many organs, as seen with the woman in the report.  

Asfaw, Sofya H., Gavin A. Falk, Careth Morris-Stiff, Ralph J. Tuthill, Matthew L. Moorman, and Micael A. Samotowka. "A Unique Cause of Intestinal and Splenic Infarction in a Sickle Cell Trait Patient." Hindawi. Hindawi Publishing Corporation, 15 Apr. 2013. Web. 09 June 2013.