Do hemoglobinopathies have any rheumatologic manifestations?
Hemoglobin S-C disease and sickle-β thalassemia may develop similar manifestations to SCD, including hand–foot syndrome and gout. Osteonecrosis of bone has been reported in both conditions. Generally, rheumatologic manifestations are less common in these other hemoglobinopathies. There are case reports of osteonecrosis occurring in patients with sickle cell trait, but the incidence is the same as in age-matched controls with normal hemoglobin. Patients with β thalassemia major (Cooley’s anemia) may develop arthropathy from marrow expansion, microfractures from osteoporosis, and scoliosis in patients surviving two decades. They do not get osteonecrosis. Chelation therapy with deferiprone (to reduce iron overload from transfusions) can cause arthralgias in 20% of patients.
