The pathology of sickle-cell disease in West Africa

Abstract
The autopsy records in the Medical Research Institute, Accra have been examined. In 2,880 autopsies the sickling phenomenon was considered to be a factor in the cause of death of 104 subjects (3.6 per cent.).The incidence of the trait in 293 necropsies was 21 per cent.Blocks of tissues were available in 40 autopsies and the pathology seen in these autopsies has been described. Classical sickle-cell anaemia occurred, but in the majority of the autopsies the spleen was enlarged and congested.The pathological lesions seen were of two types.In the first instance signs of haemolysis might be marked and were most severe in those subjects in which the small siderofibrotic spleen of sickle-cell anaemia was seen, or they might be minimal or absent even in the presence of erythrophagocytosis. Secondly blockage of the smaller vessels by sickled erythrocytes occurred and was responsible for a wide range of pathological lesions.

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