Abstract
To the Editor:
Gaston et al. (June 19 issue)
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recommended giving oral penicillin prophylaxis in children with sickle cell disease after the first four months of life, when functional asplenia starts. This recommendation cannot apply to patients with sickle cell disease who are from Saudi Arabia; they are unique and differ from patients in the United States. The most important points of difference are (1) splenic functions remain intact until early adulthood,
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and functional asplenia is not common. The reasons are thought to be in part the presence of high levels of hemoglobin F
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(20 percent). Among Saudis with sickle . . .
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