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Microvasuclar Ischemia.
Autosplenectomy - Intially there is moderate splenomegaly caused by congestion of the red pulp with masses of RBCs sickled and jammed together. Which is followed by hypoxia, leading to ischemia and infraction – leading to shruken and fibrotic spleen - This process, referred to as autosplenectomy. Autosplenectomy patients shows presence of Howell jolly bodies in peripheral smears

Increased chances of infection – encapsulated bacteria.

Vascular congestion, thrombosis, and infarction may affect any organ, including bones, liver, kidney, retina, and skin. retinal detachment, chronic leg ulcers , renal infraction, necrosis of head of long bones – AVN of femoral head , can be seen in chronic cases.

Priapism due to obstruction of penile venous outflow that may lead to fibrosis and eventual erectile dysfunction – impotence.

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