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REVIEW article

Front. Med.

Sec. Hematology

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1646682

Sickle Cell Disease, SCD: Suspect, Check, Diagnose -Practical tips for non-SCD experts to suspect and diagnose SCD in low-prevalence European settings

Provisionally accepted
Giovanni  PalazziGiovanni Palazzi1Silvia  BenemeiSilvia Benemei2*Cristiano  GallucciCristiano Gallucci2Francesco  ArcioniFrancesco Arcioni3Silverio  PerrottaSilverio Perrotta4
  • 1Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • 2medical department Pfizer Italy, Rome, Italy
  • 3Azienda Ospedaliera di Perugia, Perugia, Italy
  • 4Universita degli Studi della Campania Luigi Vanvitelli Dipartimento di Medicina Sperimentale, Naples, Italy

The final, formatted version of the article will be published soon.

Sickle cell disease (SCD) is the most common monogenic disorder, including a group of autosomal recessive hemoglobinopathies characterized by hemoglobin polymerization and sickling of red blood cells when low oxygen concentrations are present. SCD has a growing public health significance, affecting nearly 8 million people globally, with a high prevalence observed in Sub-Saharan Africa and Mediterranean countries. Improved understanding of SCD is essential, particularly given recent migratory flows that have contributed to an increase in the number of affected individuals in Europe and Italy. An early diagnosis is crucial to start the appropriate therapy to ensure the patients with the best outcome and improved quality of life, but clinical signs of SCD are often not easily recognized as symptoms are nonspecific and difficult to frame within the context of a congenital hemolytic disease. Given the availability of simple and multiple diagnostic tools, a simplified approach based on red-flags can facilitate the diagnostic suspicion in clinical practice to promptly identify individuals to be referred to specialized centers.The present narrative review aims to discuss the main clinical features, diagnostic tools of SCD, and provide practical illness scripts to facilitate the approach of non SCD-expert healthcare professionals to its diagnosis. Patient's history, including ethnicity, region of origin, familial cases of SCD and other congenital or unexplained anemias, previous clinical manifestations, remain fundamental in guiding diagnostic suspicion of SCD, together with a few crucial lab parameters. The implementation of screening projects is essential to ensure early diagnosis and rapid access to care for affected individuals.

Keywords: Sickle Cell Disease, diagnosis, medical history, Illness script, Diagnostic tools, clinical script

Received: 13 Jun 2025; Accepted: 31 Aug 2025.

Copyright: © 2025 Palazzi, Benemei, Gallucci, Arcioni and Perrotta. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Silvia Benemei, medical department Pfizer Italy, Rome, Italy

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.