Differential Diagnosis
- Single most likely diagnosis
- Sickle Cell Trait (SCT): The patient's hemoglobin electrophoresis results show 60% Hemoglobin A and 40% Hemoglobin S, which is consistent with sickle cell trait. The presence of sickle cell trait in both parents and sickle cell disease in her sister also supports this diagnosis.
- Other Likely diagnoses
- None: Given the patient's symptoms and laboratory results, sickle cell trait is the most likely diagnosis. However, it's essential to consider other possibilities, although they are less likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sickle Cell Disease (SCD): Although the patient's hemoglobin electrophoresis results are more consistent with sickle cell trait, it's crucial to consider SCD, especially given her family history. SCD can lead to severe complications, such as acute chest syndrome, ischemic stroke, and splenic infarction.
- Other hemoglobinopathies: Other hemoglobinopathies, such as hemoglobin C or E, could also be present, although they are less likely given the patient's laboratory results.
- Rare diagnoses
- Other genetic disorders: Rare genetic disorders, such as thalassemia or other hemoglobinopathies, could be considered, although they are unlikely given the patient's symptoms and laboratory results.
- Laboratory error: Although rare, laboratory error could be a possibility, and it's essential to consider this when interpreting the patient's results.
Justification
The patient's laboratory results, including her hemoglobin electrophoresis, are consistent with sickle cell trait. The presence of sickle cell trait in both parents and sickle cell disease in her sister also supports this diagnosis. While other diagnoses, such as sickle cell disease or other hemoglobinopathies, are possible, they are less likely given the patient's symptoms and laboratory results. It's essential to consider these possibilities, however, as they can have severe consequences if missed.
Most common complication of her condition
Given the patient's likely diagnosis of sickle cell trait, the most common complication is likely to be hematuria. Sickle cell trait is associated with an increased risk of hematuria, particularly in adults. However, it's essential to note that sickle cell trait is generally considered a benign condition, and most individuals with SCT do not experience significant complications.
In contrast, if the patient had sickle cell disease, the most common complications would be more severe and could include acute chest syndrome, ischemic stroke, or splenic infarction. However, given the patient's laboratory results and clinical presentation, sickle cell disease is less likely.
Therefore, the correct answer is C. Hematuria.