eMedicine Specialties > Hematology > Red Blood Cells and Disorders
Hemoglobin C Disease: Treatment & Medication
Updated: Nov 24, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Treatment
Medical Care
- Patients can usually be evaluated in an outpatient setting.
- Perform regular eye screening along with fluorescein angiography to assess for neovascularization.
Surgical Care
- Splenectomy may be indicated, and gallstones may require cholecystectomy.
- Neovascularization present at the equatorial region of the eye can be treated with a laser to prevent bleeding.
Consultations
- Dentist
- Geneticist
- Hematologist
- Ophthalmologist
Diet
No special diet is required.
Activity
Physical activities are not restricted.
Medication
Patients with hemoglobin C disease require treatment only for acute problems. Long-term antibiotic prophylaxis is not indicated.
Mineral supplementations
Iron supplementation is used to correct iron deficiency.
Ferrous sulfate (Feosol, Fer-Iron, Ferospace, Slow FE)
A nutritionally essential inorganic substance that allows transportation of oxygen via hemoglobin. Used for simple iron deficiency and iron-deficiency anemia.
Adult
325 mg/d PO
Pediatric
<12 years: Not established
>12 years: Administer as in adults
Absorption enhanced by ascorbic acid; interferes with tetracycline absorption; food and antacids impair absorption
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
GI upset; iron toxicity is observed with ingestion of large amounts and can be fatal, especially in children; parenteral (IV) administration may cause several reactions, including headaches, malaise, fever, generalized lymphadenopathy, arthralgia, and urticaria; can cause severe anaphylaxis; possible phlebitis at infusion site
More on Hemoglobin C Disease |
| Overview: Hemoglobin C Disease |
| Differential Diagnoses & Workup: Hemoglobin C Disease |
Treatment & Medication: Hemoglobin C Disease |
| Follow-up: Hemoglobin C Disease |
| Multimedia: Hemoglobin C Disease |
| References |
| Further Reading |
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References
Modiano D, Luoni G, Sirima BS, et al. Haemoglobin C protects against clinical Plasmodium falciparum malaria. Nature. Nov 15 2001;414(6861):305-8. [Medline].
Rihet P, Flori L, Tall F. Hemoglobin C is associated with reduced Plasmodium falciparum parasitemia and low risk of mild malaria attack. Hum Mol Genet. Jan 1 2004;13(1):1-6.
Olson JF, Ware RE, Schultz WH, Kinney TR. Hemoglobin C disease in infancy and childhood. J Pediatr. Nov 1994;125(5 Pt 1):745-7. [Medline].
Hingorani M, Bentley CR, Jackson H, et al. Retinopathy in haemoglobin C trait. Eye. 1996;10 ( Pt 3):338-42. [Medline].
Mantovani A, Figini I. Sickle cell-hemoglobin C retinopathy: transient obstruction of retinal and choroidal circulations and transient drying out of retinal neovessels. Int Ophthalmol. Apr 2008;28(2):135-7. [Medline].
McBrayer GM, Semes L, Stephens GG. Angioid streaks and AC hemoglobinopathy--a newly discovered association. J Am Optom Assoc. Apr 1993;64(4):250-3. [Medline].
Nagababu E, Fabry ME, Nagel RL, Rifkind JM. Heme degradation and oxidative stress in murine models for hemoglobinopathies: thalassemia, sickle cell disease and hemoglobin C disease. Blood Cells Mol Dis. Jul-Aug 2008;41(1):60-6. [Medline].
Tokumasu F, Nardone GA, Ostera GR, et al. Altered membrane structure and surface potential in homozygous hemoglobin C erythrocytes. PLoS One. 2009;4(6):e5828. [Medline]. [Full Text].
Tripette J, Alexy T, Hardy-Dessources MD, et al. Red blood cell aggregation, aggregate strength and oxygen transport potential of blood are abnormal in both homozygous sickle cell anemia and sickle-hemoglobin C disease. Haematologica. Aug 2009;94(8):1060-5. [Medline]. [Full Text].
Gabrovsky A, Aderinto A, Spevak M, et al. Low dose, oral epsilon aminocaproic acid for renal papillary necrosis and massive hemorrhage in hemoglobin SC disease. Pediatr Blood Cancer. Jan 2010;54(1):148-50. [Medline].
Dare FO, Makinde OO, Faasuba OB. The obstetric performance of sickle cell disease patients and homozygous hemoglobin C disease patients in Ile-Ife, Nigeria. Int J Gynaecol Obstet. Mar 1992;37(3):163-8. [Medline].
Fabry ME, Kaul DK, Raventos C, et al. Some aspects of the pathophysiology of homozygous Hb CC erythrocytes. J Clin Invest. May 1981;67(5):1284-91. [Medline].
Fairhurst RM, Casella JF. Images in clinical medicine. Homozygous hemoglobin C disease. N Engl J Med. Jun 24 2004;350(26):e24. [Medline].
Fairhurst RM, Fujioka H, Hayton K, et al. Aberrant development of Plasmodium falciparum in hemoglobin CC red cells: implications for the malaria protective effect of the homozygous state. Blood. Apr 15 2003;101(8):3309-15. [Medline].
Fort JA, Graham-Pole JR, Chopik J. Vasoocclusion with homozygous hemoglobin-C disease. Am J Pediatr Hematol Oncol. 1988;10(4):323-5. [Medline].
Wickramasinghe SN, Akinyanju OO, Hughes M. Dyserythropoiesis in homozygous haemoglobin C disease. Clin Lab Haematol. 1982;4(4):373-81. [Medline].
Further Reading
Clinical guidelines
Screening for sickle cell disease in newborns: U.S. Preventive Services Task Force recommendation statement.
United States Preventive Services Task Force - Independent Expert Panel. 1996 (revised 2007). 10 pages. NGC:005908
Hemoglobinopathies in pregnancy.
American College of Obstetricians and Gynecologists - Medical Specialty Society. 2007 Jan. 9 pages. NGC:005700
Clinical trial
Natural History of Sickle Cell Disease and Other Hemolytic Disorders
Related eMedicine topics
Hematologic Disease and Pregnancy
Sickle Cell Anemia
Thalassemia
Retinopathy, Hemoglobinopathies
Cholecystitis
Keywords
hemoglobin C disease, hemoglobin C, sickle cell anemia, hemolytic anemia, hemoglobin sickle, sickle cell anemia malaria, splenomegaly, cholelithiasis, gallstones, hemoglobinopathy, HbC disease, hemoglobinopathies, angioid streaks, hemoglobin C, Bruch membrane
Treatment & Medication: Hemoglobin C Disease