Extreme exertion can result in collapse and sudden death in a person with sickle cell trait. Sometimes the presence of sickle cell trait is only recognized afterwards.

Risk factors:

(1) extreme exertion

(2) hyperthermia and/or heat stress

(3) stimulant drugs

(4) infection

(5) dehydration

(5) poor physical conditioning


Cause of collapse or death:

(1) microvascular occlusion and/or DIC

(2) myocardial infarction and/or cardiac arrhythmia

(3) rhabdomyolysis and/or acute renal failure

(4) heat stroke



(1) hyperthermia

(2) myoglobinuria

(3) elevated serum CK activity

(4) hyposthenuria (urine of low specific gravity)

(5) hyperkalemia

(6) hypocalcemia

(7) hyperphosphatemia

(8) positive drug screen

(9) positive culture or PCR for micro-organism

(10) elevated fibrin split products

(11) thrombocytopenia

(12) cardiac arrhythmia

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