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Peter A. Lane, MD
University of California San Francisco

John H. Githens, MD
University of Colorado School of Medicine Denver

JAMA. 1985;254(14):1901-1902.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

Dr Steinberg's letter raises two interesting questions. The first is whether -thalassemia protects blacks with sickle cell trait from high-altitude splenic syndromes. Approximately 30% of blacks with sickle cell trait also have -thalassemia. These individuals have a lower percentage of hemoglobin S and a lower MCV than persons with sickle trait without -thalassemia.^1-3 We agree that lower concentrations of hemoglobin S in the sickle trait erythrocyte may be beneficial to those with -thalassemia. However, it is important to remember that 70% of blacks with sickle cell trait do not have -thalassemia. These individuals vastly outnumber nonblacks with sickle trait, and the percentage of hemoglobin S in their erythrocytes (40% ±0.6%)¹ is identical to that observed in our nonblack patients. Given these considerations, the disproportionate number of cases of altitude-induced splenic syndrome observed in nonblacks is likely due to factors other than the incidence of -thalassemia in . . . [Full Text PDF of this Article]

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