Granulomatous tissue in the bowel results in bloody diarrhea. Salmonella infection concurrent with schistosomiasis is common and is resistant to treatment unless the schistosomiasis is also treated. Central nervous system lesions occur, but rarely. Similar to SS disease, but milder. Vasoocclusive crises and aseptic necrosis of bone.
Crises are unusual.
Sickle cell diseases are well known as an African-American disease in the Western world, but may be missed among refugees or immigrants. The thalassemias are inherited defect in globin chain production leading to hypochromic microcytic anemia. There are about 100 geographically unique mutations that produce thalassemia phenotypes. Interestingly, these are found in areas where Plasmodium falciporum malaria was or is endemic. Thalassemia major is a life-threatening progressive hemolytic anemia.