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The page below is a sample from the LabCE course Hemoglobinopathies: Hemoglobin S Disorders. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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RBC Morphology in Sickle Cell Trait (Hb SA)

Codocytes, also referred to as target cells, are indicated by the arrows on this peripheral blood smear from a patient with sickle cell trait (Hb SA). Codocytes are cells that are present in hemoglobinopathies, thalassemia, iron deficiency, and other anemias where there is a decrease in the mean corpuscular hemoglobin concentration (MCHC).

Sickle cell trait will not usually show completely sickled cells because of the Hb A that is present in each cell. Hb A usually comprises greater than 60% of the hemoglobin in Hb SA.
However, rare drepanocytes (sickle cells) and occlusive crisis may be found during times of extreme exercise and fluid restriction.