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Q: Can lupus be mistaken as sickle cell in young children?
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If sickle-cell anemia is so destructive why hasn't the sickle-cell allele been eliminated from the population?

It is important to note that sickle-cell anemia comes in two forms. The homozygous sickle-cell anemia and the heterozygous sickle-cell trait. The difference between the two is that sickle-cell anemia has a high rate death rate at a young age (20~), and the sickle-cell trait is nearly asymptomatic.In regions such as North America, sickle-cell anemia would be selected against and would eventually leave the gene pool. The sickle-cell trait on the other hand, has little effect on the fitness of the organism, and as such will remain in the gene pool.In malaria endemic regions such as sub-Sahara Africa, sickle-cell anemia provides very high levels of immunity to malaria and the sickle-cell trait provides a slightly lesser level of immunity. Both forms of sickle-cell will increase the organisms fitness and as such, it will remain in the gene pool. Further on, the sickle-cell trait has greater fitness than sickle-cell anemia, hence, the sickle-cell trait will be selected as the fittest allele.If s is the sickle-cell allele and S is a normal allele;The relative fitness in malaria endemic regions;Ss > ss > SSSickle-cell trait > Sickle-cell anemia > NormalThe relative fitness in non-malaria endemic regions;SS > Ss > ssNormal > Sickle-cell trait > Sickle-cell anemia


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