SPLENIC INFARCTION IN SICKLEMIA DURING AIRPLANE FLIGHT: PATHOGENESIS, HEMOGLOBIN ANALYSIS AND CLINICAL FEATURES OF SIX CASES
Authors: Royal Rotter, William F. Luttgens, Wesley L. Peterson, Albert E. Stock, Arno G. Motulsky
Journal: Annals of Internal Medicine (1956)

Article1 February 1956SPLENIC INFARCTION IN SICKLEMIA DURING AIRPLANE FLIGHT: PATHOGENESIS, HEMOGLOBIN ANALYSIS AND CLINICAL FEATURES OF SIX CASESROYAL ROTTER, WILLIAM F. LUTTGENS, WESLEY L. PETERSON, ALBERT E. STOCK, ARNO G. MOTULSKY, M.D.ROYAL ROTTERSearch for more papers by this author, WILLIAM F. LUTTGENSSearch for more papers by this author, WESLEY L. PETERSONSearch for more papers by this author, ALBERT E. STOCKSearch for more papers by this author, ARNO G. MOTULSKY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-44-2-257 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptEvidence has accumulated that individuals with sicklemia, when exposed to decreased oxygen tension during airplane flight, may develop infarction of the spleen. In 1950 Sullivan1described one case of sickle cell trait with sudden splenic enlargement following an airplane flight. Since that time several reports from military establishments have appeared in the literature which have confirmed the association of splenic infarction, sicklemia and airplane flight. Cooley, Peterson, Engel and Jernigan2reported six cases of massive splenic infarction in Negroes following air travel. Each individual was treated with splenectomy. Two more cases of splenic infarction in Negroes precipitated by aerial flight...Bibliography1. Sullivan BH: Danger of airplane flight to persons with sicklemia, Ann. Int. Med. 32: 338, 1950. LinkGoogle Scholar2. CooleyPetersonEngelJernigan JCWLCEJP: Clinical triad of massive splenic infarction, sicklemia trait, and high altitude flying, J. A. M. A. 154: 111, 1954. CrossrefMedlineGoogle Scholar3. Conn HO: Sickle-cell trait and splenic infarction associated with high-altitude flying, New England J. Med. 251: 417, 1954. CrossrefMedlineGoogle Scholar4. DoengesSmithWiseBreitenbucher JPEWSPRB: Splenic infarction following air travel and associated with the sickling phenomenon, J. A. M. A. 156: 955, 1954. CrossrefMedlineGoogle Scholar5. Harvey CM: Sickle-cell crisis without anemia, occurring during air flight, Mil. Surgeon 115: 271, 1954. Google Scholar6. SmithConley EWCL: Sicklemia and infarction of the spleen during aerial flight. Electrophoresis of the hemoglobin in 15 cases, Bull. Johns Hopkins Hosp. 96: 35, 1955. MedlineGoogle Scholar7. MotulskyPaulDurrum AGMHEL: Paper electrophoresis of abnormal hemoglobins and its clinical applications. A simple semiquantitative method for the study of the hereditary hemoglobinopathies, Blood 9: 897, 1954. CrossrefMedlineGoogle Scholar8. Mourant AE: The distribution of human blood groups, 1954, Blackwell Scientific Publications, Oxford. Google Scholar9. SmithConley EWCL: Clinical features of the genetic variants of sickle cell disease, Bull. Johns Hopkins Hosp. 94: 289, 1954. MedlineGoogle Scholar10. NeelItanoLawrence JVHAJS: Two cases of sickle cell disease presumably due to the combination of the genes for thalassemia and sickle cell hemoglobin, Blood 8: 434, 1953. CrossrefMedlineGoogle Scholar11. SingerSingerGoldberg KLSR: Studies on abnormal hemoglobins. XI. Sickle cell-thalassemia disease in the Negro. The significance of the S + A + F and S + A patterns obtained by hemoglobin analysis, Blood 10: 405, 1955. CrossrefMedlineGoogle Scholar12. Sherman IJ: The sickling phenomenon, with special reference to the differentiation of sickle cell anemia from the sickle cell trait, Bull. Johns Hopkins Hosp. 67: 309, 1940. Google Scholar13. DalandCastle GAWB: A simple and rapid method for demonstrating sickling of the red blood cells: the use of reducing agents, J. Lab. and Clin. Med. 33: 1082, 1948. MedlineGoogle Scholar14. LangeMinnichMoore RDVCV: Effect of oxygen tension and of pH on sickling and mechanical fragility of erythrocytes from patients with sickle cell anemia and sickle cell trait, J. Lab. and Clin. Med. 37: 789, 1951. MedlineGoogle Scholar15. GriggsHarris RCJW: The biophysics of the variants of sickle cell disease (abstract), J. Clin. Investigation 34: 937 (June) 1955. Google Scholar16. SingerFisher KB: Studies on abnormal hemoglobin S. VII. The composition of the non-S hemoglobin fraction in sickle cell anemia bloods. A comparative quantitative study by the methods of electrophoresis and alkaline denaturation, J. Lab. and Clin. Med. 42: 193, 1953. MedlineGoogle Scholar17. WellsItano ICHA: Ratio of sickle cell anemia hemoglobin to normal hemoglobin in sicklemics, J. Biol. Chem. 188: 65, 1951. CrossrefMedlineGoogle Scholar18. Singer K: Hereditary hemolytic disorders associated with abnormal hemoglobins, Am. J. Med. 18: 633, 1955. CrossrefMedlineGoogle Scholar19. NeelKaplanZuelzer JVEW: Further studies on hemoglobin C. 1. A description of three additional families segregating for hemoglobin C and sickle cell hemoglobin, Blood 8: 724, 1953. CrossrefMedlineGoogle Scholar20. Motulsky AG: Sicklemia, J. A. M. A. 155: 388, 1954. CrossrefGoogle Scholar21. Personal Communication from Robert Bruce, M. D., Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington. Google Scholar22. Bergin KG: Aviation medicine, its theory and application, John Wright and Sons, Ltd., Bristol, pp. 18-19. Google Scholar23. FindlayBoulterMacGibbon GMEACB: A note on sickling and flying, J. Roy. Army M. Corps. 89: 138, 1947. MedlineGoogle Scholar24. Editorial: Splenic circulation, Lancet 1: 338, 1955. Google Scholar25. WatsonShapiroEllisonLichtman RJHDRRHC: Splenic aspiration in clinical and experimental hematology, Blood 10: 259, 1955. CrossrefMedlineGoogle Scholar26. WeismanHurleyHarrisHam RTJWTH: Studies on the function of the spleen in the hemolysis of red cells in hereditary spherocytosis and sickle cell disorders, J. Lab. and Clin. Med. 42: 965, 1954. Google Scholar27. GreenbergKass MSEH: Correlation of in vitro studies of blood with clinical observations in patients with the sickling phenomenon, Clin. Res. Proc. 3: 96, 1955. Google Scholar28. Diggs LW: Siderofibrosis of the spleen in sickle cell anemia, J. A. M. A. 104: 538, 1935. CrossrefGoogle Scholar29. ChapmanReederFriedmanBaker AZPSIALA: Gross hematuria in sickle cell trait and sickle cell C-hemoglobin disease, J. Lab. and Clin. Med. 44: 778, 1954. Google Scholar30. Thoma GW: The incidence and significance of sickle cell disease in deaths subject to medicolegal investigation, Am. J. M. Sc. 226: 412, 1953. CrossrefMedlineGoogle Scholar31. ChoremisIkinLehmannMourantZannos CEWHAEL: Sickle cell trait and blood groups in Greece, Lancet 2: 911, 1953. Google Scholar32. SmithConley EWCL: Filter paper electrophoresis of human hemoglobins with special reference to the incidence and clinical significance of hemoglobin C, Bull. Johns Hopkins Hosp. 93: 94, 1953. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication June 4, 1955.From the Department of Medicine, University of Washington, Seattle, Washington, and the U. S. Army and Air Force.†This investigation was supported in part by research grants from Initiative 171, State of Washington, and the U. S. Public Health Service, Contract H-1519. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySupplemental oxygen therapy recommendations in patients with sickle cell disease during air travel: A cross-sectional survey of North American health care providersMassive splenic infarction in children with sickle cell anemia and the role of splenectomySplenic Hematoma in Hb S-?+thalassemiaAcute splenic complications in children with sickle cell–hemoglobin C diseaseRetinopathy in haemoglobin C traitSplenic Infarction at Low Altitude in a Child with Hemoglobin S-C DiseaseSplenic infarction, splenic sequestration, and functional hyposplenism in hemoglobin S-C diseaseSplenic infarct in a white man with sickle cell traitSickle Cell Trait and AviationThe risk of sudden death in sickle cell trait: Noninvasive assessment of cardiac response to exercisePulmonary infarction in sickle cell traitThe morbidity of sickle cell traitSplenic sequestration syndrome at mountain altitudes in sickle/hemoglobin C diseaseThree Military Pilots with the Sickle-Cell TraitNeuropathologische Befunde bei Sichelzell-ß-ThalassämieSplenic Infarction in Sickle-Cell Trait: Are Whites More Susceptible?Sickle Cell Crisis Associated With DrugsRetinal Arterial Occlusion Following Ocular Trauma in Youths with Sickle-Trait HemoglobinopathyThe Not So Harmless Sickle TraitSudden Death in Sickle-Cell TraitThe Pathologic Anatomy of the Splenic Red PulpDie hämolytischen AnämienAnterior and Posterior Hypopituitarism Associated with Sickle Cell TraitROBERT A. PASTURE, JAMES W. ANDERSON, ROBERT H. HERMANDRUGS, ANESTHESIA AND ABNORMAL HEMOGLOBINSDRUGS, ANESTHESIA AND ABNORMAL HEMOGLOBINSSICKLÆMIC HUMAN HYGROMETERSSickle Cell Trait and Superior Longitudinal Sinus ThrombosisERIC A. SCHENK, M.D.Pulmonary sarcoidosis with progressive central nervous system symptoms requiring craniotomyMassive Intravascular Sickling after Exchange Transfusion with Sickle Cell Trait BloodAvascular Necrosis of the Femoral Head Associated with Sickle Cell Trait (AS Hemoglobin)RALPH G. RATCLIFF, M.D., MELVYN D. WOLF, M.D.Abdominal crises associated with sicklemia and airplane flightsPulmonary Infarction and Atrophy of the Spleen Associated with Sickle-Cell Hemoglobin C DiseaseIncidence and significance of abnormal hemoglobinsDominance and recessivity in medical geneticsTreatment of hemolytic disordersMOLECULAR DISEASES OF HEMOGLOBIN. I. INTRODUCTION AND INCIDENCE*TOM P. HAYNIE, M.D., HAROLD L. DOBSON, M.D., ROBERT A. HETTIG, M.D.Clinical Picture of Sickle-cell Disease 1 February 1956Volume 44, Issue 2Page: 257-270KeywordsArmed forcesHemoglobinHypoxiaInfarctionMedical servicesOxygenPathogenesisResearch grantsSpleenSplenectomy ePublished: 1 December 2008 Issue Published: 1 February 1956 PDF downloadLoading ...