On 70 per cent of the blood smears from 60 cases of electrophoretically proven sickle cell-hemoglobin C disease, there is observed a misshapen erythrocyte that contains condensed hemoglobin crystals which are dark-hued, homogeneous and elongated and which have parallel sides with one end terminating in a pyramid or rounded shape. A red blood corpuscle may have multiple protuberances at varying angles to each other. The incidence of intracellular hemoglobin crystals was found to be 0-24 per 1000 red blood cells with an average of 3.2/1000. Recognition of this unusual morphology is presumptive evidence of sickle cell-hemoglobin C and warrants examination by electrophoretic procedures.
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Diggs et al. (1965) studied this question.