Abstract
Exertional sickling from sickle cell trait (SCT) can pose a grave risk for some military recruits and is a troubling cause of death in college athletes. We report the cases of two U.S. Army recruits with undetected SCT who collapsed and soon died from metabolic complications of exertional sickling as they struggled to finish in time the 2-mile run of the Army Physical Fitness Test, having failed this test on prior attempts. These cases are similar to other military cases and to recent sickling deaths in college track and football. Research shows how and why, in the face of SCT, during intense exercise bouts, sickle cells can quickly form and lead to fulminant rhabdomyolysis that can be fatal. Increasing evidence suggests that, in the military and in sports, the proximate trigger for most cases of fatal sickling collapse is intensity. If this hypothesis is correct, that sickling collapse is an intensity syndrome, it raises vital questions about how best to train military recruits with SCT.
Citations
Aug 7, 2013·Chronobiology International·Mor DiawJulien Tripette
Aug 7, 2013·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Irfan M AsifDavid Klossner
Jun 5, 2017·Journal of Genetic Counseling·Mary Anne McDonaldCharmaine Dm Royal
May 26, 2018·Sports Medicine - Open·Bruce L Mitchell
May 6, 2019·Southern Medical Journal·Carroll FlansburgLorena Madrigal
May 15, 2019·Current Sports Medicine Reports·E Randy Eichner
Mar 7, 2020·Current Sports Medicine Reports·E Randy Eichner
Sep 1, 2015·Journal of Racial and Ethnic Health Disparities·Caroline K ThoresonAnne E Sumner
Aug 16, 2016·The New England Journal of Medicine·D Alan NelsonLianne M Kurina
May 14, 2016·Current Sports Medicine Reports·E Randy Eichner
Jun 2, 2018·The Physician and Sportsmedicine·Terry L ThompsonCina R Karodeh
Dec 17, 2015·Sports Medicine·Erica N ChiricoVincent Pialoux
Feb 18, 2020·Military Medicine·Charles Magee, Mark C Haigney
Mar 10, 2020·The Physician and Sportsmedicine·Rebecca M HirschhornSusan Yeargin
Sep 2, 2021·Clinical Case Reports·Muntadhar Al Moosawi, Hatoon Ezzat
May 3, 2019·Pediatric Emergency Care·Caroline Newman, Karl B Fields