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People with the heterozygous hemoglobin genotype AS have sickle cell trait. These persons are hematologically normal, with no anemia and normal red blood cells on peripheral blood smear. A screening test for sickle hemoglobin will be positive, and Hemoglobin electrophoresis will reveal that approximately 40% of hemoglobin is hemoglobin S (Table 13–9). People with sickle cell trait experience more rhabdomyolysis during vigorous exercise but do not have increased mortality compared to the general population. They may be at increased risk for venous thromboembolism. Chronic sickling of red blood cells in the acidotic renal medulla results in microscopic and gross hematuria, hyposthenuria (poor urine concentrating ability), and possibly chronic kidney disease. No treatment is necessary but genetic counseling is recommended.

Liem  RI. Balancing exercise risk and benefits: lessons learned from sickle cell trait and sickle cell anemia. Hematology Am Soc Hematol Educ Program. 2018 Nov 30;2018(1):418–25.
[PubMed: 30504341]  
Pecker  LH  et al. The current state of sickle cell trait: implications for reproductive and genetic counseling. Hematology Am Soc Hematol Educ Program. 2018 Nov 30;2018(1):474–81.
[PubMed: 30504348]  

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