Trait Counseling Manual: Sickle Cell Trait and Hemoglobin C Trait
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1 Trait ounseling Manual: ickle ell Trait and Hemoglobin Trait
2 Trait ounseling Manual: ickle ell Trait and Hemoglobin Trait Produced by t. Jude hildren s Research Hospital, Departments of Hematology, Patient Education, and Biomedical ommunications 1 This document is not intended to replace counseling by a trained health care professional or genetic counselor. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your doctor. opyright 2008 t. Jude hildren s Research Hospital Revised pril 2008
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4 Hemoglobin Trait Hemoglobin (HEE-muh-glow-bin) is the main ingredient inside red blood cells. Hemoglobin helps red blood cells carry oxygen from the lungs to other parts of the body. ome people have an abnormal kind of hemoglobin in their red blood cells mixed with normal hemoglobin. These people have a trait condition that is inherited (in-hir-uh-ted) from parents, just like eye color or hair color. Trait ondition vs. Disease Trait is not disease. Normally a trait condition will not make you sick. It you have a hemoglobin trait; you can pass it to your child. If both you and your partner have a hemoglobin trait, you can have a child with disease, so it is important to know your hemoglobin status. 3 In this booklet, we will: how how normal red blood cells carry oxygen to the body; Describe sickle cell trait and hemoglobin trait and how they affect red blood cells; and Explain how 2 people with these trait conditions can have a child with sickle cell disease or hemoglobin disease.
5 Inside Red Blood ells Normal blood cells contain only hemoglobin. People who do not have a hemoglobin trait condition have only hemoglobin inside their red blood cells. Normal red blood cell Movement of Normal Red Blood ells 4 Hemoglobin makes red blood cells soft and round. This helps red blood cells pass easily through blood vessels, carrying oxygen throughout the body. ome people have hemoglobin and an abnormal hemoglobin in their red blood cells. This is a hemoglobin trait condition. It is inherited, like eye color or hair color. Two of the most common hemoglobin traits are: ickle cell trait; and Hemoglobin trait. First, let s look at sickle cell trait.
6 ickle ell Trait bout one (1) out of every 10 frican-mericans has sickle cell trait, and about one (1) out of every 100 Hispanic mericans/latinos has sickle cell trait. This trait also affects many people whose ancestors came from Latin merica, sia, frica, India, and the Mediterranean region. It is possible for a person of any race or nationality to have sickle cell trait. It is believed that sickle cell trait first appeared long ago in areas of the world where people were sick with malaria. Usually, a person with sickle cell trait has increased protection against malaria. 5
7 People with sickle cell trait have red blood cells that hold normal hemoglobin and an abnormal hemoglobin. The abnormal hemoglobin is called hemoglobin. People with sickle cell trait have slightly more hemoglobin than hemo- globin. They have enough hemoglobin to help their red blood cells carry oxygen to the body. Only in extreme cases would this trait cause health problems. ickle ell Trait Red Blood ell People with sickle cell trait do not have sickle cell disease. They cannot develop sickle cell disease later in life. They can pass sickle cell trait to their children. How ickle ell Trait is Inherited 6 ickle cell trait is inherited from one s parents, like hair color or eye color. If one (1) parent has sickle cell trait and the other parent has normal hemoglobin, there is a 50 percent (1 in 2) chance with each pregnancy of having a child who has sickle cell trait. ickle ell Trait () No Trait Normal Hemoglobin () ickle ell Trait () ickle ell Trait () No Trait () No Trait ()
8 Recap: ickle ell Trait Facts People with sickle cell trait usually do not have any health problems caused by the trait. People with sickle cell trait can never develop sickle cell disease. People with sickle cell trait can have a child with sickle cell trait. Why is it Important to Know if I Have ickle ell Trait? Parents who have sickle cell trait can have a child with sickle cell disease. ickle cell disease can cause serious health problems. That is why it is important to understand how sickle cell trait is passed on and how it can affect the health of your children and grandchildren. 7
9 What is ickle ell Disease? ickle cell disease is the name for a group of illnesses. These lifelong illnesses make it hard for red blood cells to get oxygen to the body. They can cause pain and lead to serious health problems. There are many types of sickle cell disease. Two of the most common types are: ickle cell anemia (also known as hemoglobin disease); and ickle-hemoglobin disease (also known as hemoglobin disease). Let s look first at sickle cell anemia. 8
10 ickle ell nemia and Red Blood ells People who have sickle cell anemia have red blood cells that contain mostly hemoglobin. Under certain conditions, these red blood cells harden and take on a sickle (or banana) shape. Their shape and texture make it hard for these cells to flow through small blood vessels and to deliver oxygen to some parts of the body. This can cause cell damage and pain. 9 Red Blood ell in People with ickle ell nemia
11 If both parents have sickle cell trait, they can have a child with sickle cell anemia. These are the possible outcomes with each pregnancy. 50 percent (1 in 2) chance of having a child with sickle cell trait 25 percent (1 in 4) chance of having a child with sickle cell anemia 25 percent (1 in 4) chance of having a child without sickle cell trait and without sickle cell anemia ickle ell Trait () ickle ell Trait () 10 ickle ell Disease () ickle ell Trait () ickle ell Trait () No Trait () Review How ickle ell Trait and ickle ell nemia are Inherited If one (1) parent has sickle cell trait and the other parent has normal hemoglobin, there is a 50 percent (1 in 2) chance with each pregnancy of having a child with sickle cell trait. If both parents have sickle cell trait, there is a 25 percent (1 in 4) chance with each pregnancy of having a child with sickle cell anemia. The only way to know if you have sickle cell trait is to have a simple blood test.
12 Review ickle ell Trait and ickle ell nemia Normal ickle ell Trait ickle ell nemia No serious health problems ickle-shaped cells block normal blood flow causing serious health problems 11
13 Hemoglobin Trait nother trait condition is called hemoglobin trait. bout one (1) out of every 40 frican-mericans has hemoglobin trait. This trait also affects people whose ancestors came from Italy, Greece, frica, Latin merica, and the aribbean region. 12
14 To understand hemoglobin trait, it helps to remember that normal blood cells contain only hemoglobin. People who do not have hemoglobin trait (or another trait condition) have only hemoglobin inside their red blood cells. Normal red blood cell Hemoglobin Trait and Red Blood ells People with hemoglobin trait have red blood cells that hold normal hemoglobin and an abnormal hemoglobin. The abnormal hemoglobin is called hemoglobin. People with hemoglobin trait have slightly more hemoglobin than hemoglobin. They have enough hemoglobin to help their red blood cells carry oxygen to the body. People with hemoglobin trait do not have sickle cell disease. They do not have hemoglobin disease. They cannot develop these diseases later in life. They can pass hemoglobin trait to their children. 13 Hemoglobin trait red blood cell
15 How Hemoglobin Trait is Inherited Hemoglobin trait is inherited from one s parents, like hair color or eye color. If one (1) parent has hemoglobin trait and the other parent has normal hemoglobin, there is a 50 percent (1 in 2) chance with each pregnancy of having a child who has hemoglobin trait. Recap: Hemoglobin Trait Facts People with hemoglobin trait usually do not have any health problems caused by the trait. Hemoglobin Trait () No Trait Normal Hemoglobin () People with hemoglobin trait can never develop sickle 14 cell disease or hemoglobin disease. People with hemoglobin trait can have a child with hemoglobin trait. Hemoglobin Trait () Hemoglobin Trait () No Trait () No Trait () Why is it Important to Know if I Have Hemoglobin Trait? Hemoglobin trait is an inherited condition. That means you can pass it on to your children, and they can pass it on to their children. People who have hemoglobin trait also can have a child with a form of sickle cell disease called sickle-hemoglobin disease. ickle-hemoglobin disease (also known as hemoglobin disease) is a lifelong illness that can cause serious health problems.
16 ickle-hemoglobin Disease and Red Blood ells People who have sickle-hemoglobin disease have red blood cells that contain both hemoglobin and hemoglobin. Under certain conditions, these red blood cells harden and take on a sickle (or banana) shape. Their shape and texture make it hard for these cells to flow through small blood vessels and deliver oxygen to some parts of the body. This can cause cell damage and pain. 15 Red blood ell in People with ickle-hemoglobin Disease
17 If one (1) parent has sickle cell trait and the other parent has hemoglobin trait, they can have a child with sickle-hemoglobin disease. These are the possible outcomes with each pregnancy. 25 percent (1 in 4) chance of having a child with hemoglobin trait 25 percent (1 in 4) chance of having a child with sickle cell trait 25 percent (1 in 4) chance of having a child with sickle-hemoglobin disease Hemoglobin Trait () ickle ell Trait () 25 percent (1 in 4) chance of having a child without 16 trait and without sickle-hemoglobin disease Hemoglobin Trait () ickle ell Trait () ickle- Hemoglobin Disease () No Trait () Review How Hemoglobin Trait and ickle-hemoglobin Disease are Inherited If one (1) parent has hemoglobin trait and the other parent has normal hemoglobin, there is a 50 percent (1 in 2) chance with each pregnancy of having a child with hemoglobin trait. If one parent has sickle cell trait and the other parent has hemoglobin trait, with each pregnancy there is a 25 percent (1 in 4) chance of having a child with sickle-hemoglobin disease (a form of sickle cell disease). This is a lifelong illness that can cause serious health problems. The only way to know if you have hemoglobin trait is to have a simple blood test.
18 Review Hemoglobin Trait and ickle-hemoglobin Disease Normal Hemoglobin Trait ickle-hemoglobin Disease No health problems ickle-shaped cells block normal blood flow causing serious health problems 17
19 Hemoglobin Disease People with hemoglobin trait also can have a child with hemoglobin disease. Hemoglobin disease is not a form of sickle cell disease. People who have hemoglobin disease have red blood cells that contain mostly hemoglobin. Too much hemoglobin can reduce the number and size of red blood cells in your body, causing mild anemia. Hemoglobin disease usually does not cause serious health problems. Red blood ell in People with Hemoglobin Disease 18 If both parents have hemoglobin trait, they can have a child with hemoglobin disease. These are the possible outcomes with each pregnancy. 50 percent (1 in 2) chance of having a child with hemoglobin trait 25 percent (1 in 4) chance of having a child with hemoglobin disease 25 percent (1 in 4) chance of having a child without hemoglobin trait and without hemoglobin disease Hemoglobin Trait () Hemoglobin Trait () Hemoglobin Disease () Hemoglobin Trait () Hemoglobin Trait () No Trait ()
20 Review How Hemoglobin Trait and Hemoglobin Disease are Inherited If one (1) parent has hemoglobin trait and the other parent has normal hemoglobin, there is a 50 percent (1 in 2) chance with each pregnancy of having a child with hemoglobin trait. If both parents have hemoglobin trait, there is a 25 percent (1 in 4) chance with each pregnancy of having a child with hemoglobin disease. People with hemoglobin disease usually do not have serious health problems. The only way to know if you have hemoglobin trait is to have a simple blood test. Review Hemoglobin Trait and Hemoglobin Disease Normal Hemoglobin Trait Hemoglobin Disease 19 No health problems Mild anemia, usually no serious health problems
21 To learn more about trait conditions, talk to your doctor or genetic counselor. This staff member can give you more details about your trait status and that of your child. lso, for more information, you can visit our Web site at Other Web sites of interest are published by the ickle ell Disease ssociation of merica ( and by the Georgia omprehensive ickle ell enter at Grady Health ystem ( t. Jude hildren s Research Hospital does not endorse the content of any other Web sites provided in this manual. 20
22 The omprehensive ickle ell enter t. Jude hildren s Research Hospital Department of Hematology 332 N. Lauderdale t., Mail top 800 Memphis, TN /08 Biomedical ommunications
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