Hemolytic anemia

Sickle cell disease

Topic Completed: 1 December 2006

Minor changes: 13 May 2021

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PubMed Search: Sickle cell disease [title] bone marrow [title]

Nat Pernick, M.D.
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Cite this page: Pernick N. Sickle cell disease. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/hematologysicklecelldisease.html. Accessed September 20th, 2021.
Definition / general
  • High sinusoidal blood flow in bone marrow predisposes it to blood stasis, causing regional hypoxia, acidosis, sickling and then thrombosis and infarction
  • Other complications are osteomyelitis and avascular necrosis
Diagrams / tables

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Case reports
Clinical features
  • Associated with increases in thrombin generation, fibrinolytic activation, platelet activation, increased antiphospholipid antibodies, decreased levels of circulating anticoagulants and contact factors
  • Also increased circulating levels of tissue factor and endothelial cells expressing a tissue factor phenotype
  • Have hypercoagulable state based on thermoelastographic profiles (Arch Pathol Lab Med 2005;129:760, J Clin Pathol 1980;33:622)
Microscopic (histologic) description
  • May have increased normoblasts and megaloblastic changes due to folate deficiency
  • Increased perivascular fibrosis in small and medium sized vessels (Arch Pathol Lab Med 2004;128:634)
  • Occasional aplastic crisis
Microscopic (histologic) images

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Infarction of medullary cavity

Peripheral smear images

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Sickled erythrocytes

Positive stains
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