{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T10:34:19Z","timestamp":1784802859904,"version":"3.55.0"},"reference-count":20,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Sickle cell trait carriers are generally considered asymptomatic; nevertheless, there are potential complications. The spleen is vulnerable to infarction because of its role in trapping and removing sickle cells and its hypoxic environment. In this report, a case of a 31-year-old physically active man who experienced severe abdominal pain near the peak of the Acatenango Volcano in Guatemala is described. At the hospital, he was diagnosed with splenic infarction, requiring splenectomy. Pathological analysis of the spleen revealed interstitial hemorrhage and marked congestion of capillaries by sickle-shaped erythrocytes. Laboratory studies revealed no evidence of anemia or any alteration in the red blood cell formula; however, leukocytosis was observed at the time of the event, which rapidly decreased on subsequent days. In contrast, platelets increased after the spleen removal. Capillary electrophoresis revealed the sickle cell carrier state. Genetic alterations associated with thrombophilia, alpha thalassemia, and other beta globin hemoglobinopathies were absent. This case reinforces evidence that high-altitude hypoxia can trigger sickle cell formation in heterozygous carriers and lead to splenic damage.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0227","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T15:03:46Z","timestamp":1759849426000},"page":"1442-1445","source":"Crossref","is-referenced-by-count":1,"title":["Histopathologic and Molecular Evidence of Splenic Infarction Associated with Sickle Cell Trait: An Instructive Case in Central America"],"prefix":"10.4269","volume":"113","author":[{"given":"Joby","family":"Robleto-Quesada","sequence":"first","affiliation":[{"name":"Clinical Analysis Department, University of Costa Rica, San Jos\u00e9, Costa Rica;"},{"name":"Hematology and Related Disorders Research Center (CIHATA), University of Costa Rica, San Jos\u00e9, Costa Rica;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Jara-Segura","sequence":"additional","affiliation":[{"name":"Clinical Analysis Department, University of Costa Rica, San Jos\u00e9, Costa Rica;"},{"name":"Hematology and Related Disorders Research Center (CIHATA), University of Costa Rica, San Jos\u00e9, Costa Rica;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9-Ricardo","family":"Montenegro","sequence":"additional","affiliation":[{"name":"Cl\u00ednica B\u00edblica Hospital, San Jos\u00e9, Costa Rica;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Mauricio","family":"Siliezar-Tala","sequence":"additional","affiliation":[{"name":"Hematopathology and Oncopathology Specialized Center, Ciudad de Guatemala, Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jose","family":"Su\u00e1rez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Hematology and Related Disorders Research Center (CIHATA), University of Costa Rica, San Jos\u00e9, Costa Rica;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jos\u00e9","family":"Madrigal-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Hematology and Related Disorders Research Center (CIHATA), University of Costa Rica, San Jos\u00e9, Costa Rica;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"2018","article-title":"Sickle-cell disease","volume":"376","author":"Rees","year":"2010"},{"key":"b2","series-title":"Nat Rev Dis Primers","first-page":"18010","article-title":"Sickle cell disease","volume":"4","author":"Kato","year":"2018"},{"key":"b3","series-title":"Haematologica","first-page":"1106","article-title":"The carrier state for sickle cell disease is not completely harmless","volume":"104","author":"Xu","year":"2019"},{"key":"b4","series-title":"Hematology Am Soc Hematol Educ 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Med","first-page":"1125","article-title":"Assessment of clinical conditions associated with splenic infarction in adult patients","volume":"180","author":"Brett","year":"2020"},{"key":"b19","series-title":"N Engl J Med","first-page":"1177","article-title":"Thrombophilia testing and venous thrombosis","volume":"377","author":"Connors","year":"2017"},{"key":"b20","series-title":"Biomedica","first-page":"1","article-title":"Haplotipos del gen beta globina en portadores de hemoglobina S en Colombia","volume":"32","author":"Dur\u00e1n","year":"2012"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/6\/article-p1442.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/6\/article-p1442.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/6\/article-p1442.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T13:32:54Z","timestamp":1764768774000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/6\/article-p1442.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,3]]},"references-count":20,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0227","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,3]]}}}