Former Guards and Nurse Charged In Death Of Boy at Juvenile Boot Camp

An initial autopsy by medical examiner Dr. Charles Siebert found Anderson died of complications of sickle cell trait, a usually benign blood disorder.

Mortality in sickle cell disease. Life expectancy and risk factors for early death.

Among children and adults with sickle cell anemia (homozygous for sickle hemoglobin), the median age at death was 42 years for males and 48 years for females. Among those with sickle cell-hemoglobin C disease, the median age at death was 60 years for males and 68 years for females. Among adults with sickle cell disease, 18 percent of the deaths occurred in patients with overt organ failure, predominantly renal. Thirty-three percent were clinically free of organ failure but died during an acute sickle crisis (78 percent had pain, the chest syndrome, or both; 22 percent had stroke).

Modeling revealed that in patients with sickle cell anemia, the acute chest syndrome, renal failure, seizures, a base-line white-cell count above 15,000 cells per cubic millimeter, and a low level of fetal hemoglobin were associated with an increased risk of early death.

A large proportion of those who died had no overt chronic organ failure but died during an acute episode of pain, chest syndrome, or stroke. Early mortality was highest among patients whose disease was symptomatic. A high level of fetal hemoglobin predicted improved survival and is probably a reliable childhood forecaster of adult life expectancy.

Sickle Cell Trait

Sickle cell trait usually is not regarded as a disease state because it has complications that are either uncommon or mild. Nevertheless, under unusual circumstances serious morbidity or mortality can result from complications related to polymerization of deoxy-hemoglobin S. Such problems include increased urinary tract infection in women, gross hematuria, complications of hyphema, splenic infarction with altitude hypoxia or exercise, and life-threatening complications of exercise, exertional heat illness (exertional rhabdomyolysis, heat stroke, or renal failure) or idiopathic sudden death (1-4). Pathologic processes that cause hypoxia, acidosis, dehydration, hyperosmolality, hypothermia, or elevated erythrocyte 2,3-DPG can transform silent sickle cell trait into a syndrome resembling sickle cell disease with vaso-occlusion due to rigid erythrocytes. Compound heterozygous sickle cell disease can be mistaken as uncomplicated sickle cell trait, particularly when an unusual globin variant is involved.

Complications from sickle cell trait are important because about three million people in the United States have this genotype, about 40 to 50 times the number with sickle cell disease.

An important potential complication of sickle cell trait is unexpected exercise-related death (ERD). The validity of this association aroused heated controversy (4). The possibility that previously healthy young people with sickle cell trait might suffer increased mortality from exercise was first suggested by observations of enlisted recruits in US Armed Forces basic training. A military trainee with Hb AS suffered exercise related hypernatremia during physical training in the field. He only survived a critical illness that included acute renal failure because of dialysis (8). During a single summer, there were four exercise-related deaths among recruits at Fort Bliss, all of whom were black and had sickle cell trait, while no recruits with normal hemoglobin died. Only 1.5% of these recruits had sickle cell trait. The authors suggested a significant risk association with sickle cell trait (8).

Originally posted by Landis
So, these people are required to have ESP now as well? That is, in addition to being lawyer and nursemaid?

Originally posted by Landis
So, these people are required to have ESP now as well? That is, in addition to being lawyer and nursemaid?

Anyone here ever done this job?