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 Disease (Hb SS)

Sickle cell anemia (Hb SS) is a hemolytic anemia, characterized by the presence of drepanocytes (sickle cells) and polychromasia (increased reticulocytes). Nucleated red blood cells (NRBCs) may be seen during episodes of severe hemolysis. The absence of polychromasia may indicate aplastic crisis.
The homozygous state of Hb SS causes RBCs to take on the characteristic sickle shape when hemoglobin is in a deoxygenated state. The name "sickle" comes from the tool (seen in the upper image) that is used to manually cut hay. When RBCs sickle they take on the same shape as the blade of the sickle, as seen in the bottom image.