The Medical Mystery of Sasha Fierce By: Doctors Vanessa L’Abbate, Sarah Danzinger and Lydia Torres

Diagnosis of Sasha Fierce: After overlooking your symptoms, your test results and medical history we draw the conclusion that you have Sickle Cell Anemia.

Some Facts About Sickle Cell Anemia: Sickle cell anemia is passed down through families in which red blood cells form an abnormal crescent shape. Hemoglobin is a protein inside red blood cells that carries oxygen. Sickle cell anemia is caused by an abnormal type of hemoglobin called hemoglobin S. Hemoglobin S distorts the shape of red blood cells, especially when exposed to low oxygen levels. Sickle cell anemia is inherited from both parents. Sickle cell anemia is much more common in African American women.

Family Medical History: On your family history section of your medical records you checked off Heart Disease. This doesn’t relate much to your illness although you do have a gene from your family that shows Sickle Cell Anemia: Hemoglobin variant Hb S (HBB) gene. This was found in your Genetic Screening test.

Symptoms That Relate to Your Illness Over our research we noticed that you have a lot of the symptoms of the disease. Sickle Cell Anemia effects the Circulatory system, Excretory system and Respiratory system. Here are your symptoms that relate to those systems: Painful/bloody urination- relates to Circulatory system and Excretory system. Short of Breath with exertion- Respiratory system and Circulatory system. Sluggish/ Fatigue- Circulatory system. If you haven’t noticed yet, the Circulatory system is in each one of your symptoms. The Circulatory system is most the effected with Sickle Cell Anemia. Other symptoms that relate to your illness is Jaundice (yellow skin) and paleness.

Test Results: * CBC: Low oxygen, low iron, low red blood cell volume * White Blood Count - 6,500 cells/mL * Red Blood Count million cells/mm3 * Hemoglobin g/dL * Hematocrit - 26% * Images of the RBC also indicate a distorted shape * MRI: Normal * Hormone Levels Normal * Pregnancy Test Negative * Stress Test Not enough energy to complete test * Blood Iron Level Blood Iron: 32% * Genetic Screening Found hemoglobin variant Hb S (HBB) gene * Oxygen levels: seems to be quite low and related to a hemoglobin deficiency

Possible Treatment There is no available cure yet. I suggest you get regular medical care. Hematologists specialize in treating adults and children who have blood diseases or disorders. Severe sickle cell anemia can be treated with a medicine called hydroxyurea. This medicine prompts your body to make fetal hemoglobin. Fetal hemoglobin, or hemoglobin F, is the type of hemoglobin that newborns have. Adults who have sickle cell anemia also should have flu shots every year and get vaccinated against pneumonia. On your medical records it says you haven’t had your pneumonia vaccine yet so you should get it as soon as possible. A blood and marrow stem cell transplant can help treat sickle cell anemia and may even offer a cure for a small number of people. The stem cells used for a transplant must come from a closely matched donor. This usually is a close family member who doesn't have sickle cell anemia. This treatment is risky and can cause serious side effects or even death. You can join a support group where members share common experiences and problems to relieve any stress over the disease.