A 33-year-old female with a history of sickle cell trait (sickle cell trait

SCT) presented anemia on routine blood test during follow-up at the Department of Cardiology

Shanghai Jiahui International Hospital in August 2022. She had no signs of mucocutaneous hemorrhage

hematemesis

melena or other gastrointestinal bleeding

and was subsequently referred to the Department of Hematology for further evaluation. The patient complained of recurrent right lower extremity muscle pain accompanied by dizziness and general fatigue. Family history: a maternal family history of anemia

while her siblings had no history of anemia. Laboratory examinations revealed microcytic hypochromic anemia with a reticulocyte (Ret) count of 1.21%. Peripheral blood smear showed anisocytosis

with sickled red blood cells accounting for 4.00% and target cells accounting for 12.5%. Iron metabolism tests: serum ferritin (Fer) 10 μg/L

serum iron (Fe) 7.83 μmol/L. Hemoglobin zone electrophoresis demonstrated hemoglobin S (HbS) 27.00%

hemoglobin A₂ (HbA₂) 3.80%

hemoglobin A (HbA) 69.20%

and hemoglobin F (HbF) 0.00%. Genomic testing for hereditary hematological diseases identified a heterozygous HBB gene CD6 (GAG>GTG) mutation combined with homozygous -α³·⁷ deletion. Based on the patient’s medical history

family history and laboratory findings

the final diagnosis was sickle cell trait complicated with homozygous α-thalassemia and iron deficiency anemia. The patient received standardized intravenous iron supplementation with iron sucrose injection. Complete blood count and serum ferritin were monitored regularly to prevent iron overload. The patient was advised to avoid strenuous exercise and overexertion and keep warm in daily life. During follow-up

iron deficiency anemia was effectively corrected

and hemoglobin returned to the normal reference range. The proportion of sickled red blood cells in peripheral blood smears decreased

whereas the proportion of target cells remained stable. No serious adverse events including iron overload

hemolytic crisis or vaso-occlusive complications were observed

and the patient’s condition remained stable overall.