Rheumatic fever, rheumatic arthritis, acholuric jaundice were excluded in this case on the clinical and laboratory findings. The history, physical examination and the laboratory studies all supported the diagnosis of sickle cell anemia.
This case presents certain points of interest. It is the first case of sickle cell anemia reported from Egypt. The disease was found in the patient and her father and excluded in the other members of the family. It is, however, possible that the paternal uncle had also suffered and died from the disease.
The patient is a white girl and admixture of Negro blood was reasonably excluded through 6 ancestral generations. This case, therefore, adds to those already described in subjects of the white race from the Mediterranean area. It will be noticed that the patient’s family originates from Algeria, where 3 cases were diagnosed in natives by Smith19 on the basis of the anatomical changes observed in the spleen.