Sickled erythrocytes in urine as a clue to the diagnosis of sickle cell trait.

Sickled erythrocytes in patients of sickle cell trait with microscopic hematuria have rarely been reported so far. A 30-year-old female underwent delivery of a healthy full-term baby by cesarean section. However, postcesarean, she had pain in abdomen and fever, for which she was advised blood and urine examination. The hemogram suggested mild leukocytosis with neutrophilia and the urine showed red blood cells, some of which were sickled. The patient was advised hemoglobin electrophoresis which suggested sickle cell trait (Hb-AS). We conclude that sickled erythrocytes should not be ignored in a sample of urine as it may serve as an important clue to the diagnosis of sickle cell trait or disease.

Renovasculopathies in elderly normotensives of Bombay, India.

In essential hypertension, specific vasculopathies distinguish the kidney of nephrosclerosis. The severity of renovasculopathy can be measured histologically at autopsy. A previously determined equation uses the measurements to calculate mean blood pressure levels. That equation did not encompass elderly subjects with minimal vasculopathy, because they were deficient in the previous data set. Such subjects were abundant in a series of 86 autopsies conducted at the J.J. Hospital in Bombay. That newly reviewed series now provides many instances of normotension accompanying minimal vasculopathy at ages greater than 40-50 years. These conditions are seldom observed in the U.S.A. The newly examined elderly normotensives manifest degrees of renovasculopathy equivalent to those of youthful normotensives with comparable blood pressure levels. The elderly subjects who escaped a rise of blood pressure with age were those with long delayed progression of renovasculopathy; this may be the explanation for avoidance of hypertension in old age. The outcome places the J.J. Hospital patients among the populations of the world with the slowest rates of progression of hypertension.