Vasocclusive events in the sickle-cell syndromes have multiple determinants: first and
foremost is the capacity of red cells to undergo intracellular polymerization of deoxy HbS.
However, the impact of the sicklable red cell is not limited to mechanical obstruction of the
microcirculation, but also results in other and sometimes unexpected consequences. For
example, red-cell destruction leads to large numbers of young red cells with enhanced
vascular adhesion and increased K: Cl cotransport expression, in addition to an elevated …