This is often associated with an infection by Parvovirus B-19. The bone marrow's replacement of the cells is disrupted. This usually manifests with a rapid drop in hemoglobin levels. Luckily, this condition is usually self limited, and the treatment is mostly supportive. Recovery is usually heralded by an increase in the reticulocyte count.

In children and in adolescents, sickle cell disease causes growth retardation, a delay in the manifestation of secondary sexual characteristics and sexual maturation, and usually results in the child being significantly underweight. It often happens in childhood that the spleen enlarges, especially in the first year of life, resulting from the sequestration of a large number of sickled cells within the spleen. This is a painful process. The spleen will then have repeated infarcts, and splenic function is impaired during the enlargement. Eventually, the repeated episodes of infarct leave the spleen fibrotic and it shrinks in size,...
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