ABSTRACT
This chapter looks at issues in the clinical management of athletes where the risk of splenic rupture is increased because of sickle cell disease. It also looks first at the physiopathology of sickling and its impact upon physical performance and other aspects of health. Sickle cell disease is often associated with poor physical and mental health, a low level of habitual physical activity, cardiac enlargement, non-specific ECG changes and an impaired physical performance. Given that inheritance influences many aspects of athletic performance, it is not surprising that sickle cell trait is associated with success in some types of competition. Some authors have described autonomic disturbances, abnormal capillary blood flow and sudden death in individuals with sickle cell trait even during sleep, but others argue that the evidence supporting sickling episodes while sleeping is not convincing. Homozygotes with overt sickle cell disease must expect painful sickling episodes, a reduced quality of life, pulmonary hypertension and orthopaedic or neurologic complications.
