Don't forget sickled cells in the urine when investigating a patient for haematuria

Haematuria is a well-known complication of sickle cell disease. A South African coloured patient with repeated episodes of gross haematuria is described in whom the diagnosis of sickle cell disease was suggested after the finding of sickled erythrocytes in the urine sediment. The diagnosis was then confirmed by haemoglobin electrophoresis, which revealed sickle cell trait (Hb-AS). It is concluded that sickled erythrocytes must be looked for when urine is microscopically scrutinized to determine the source of a haematuria.