Some hereditary defects in red blood cell membrane proteins may make an erythrocyte more susceptible to thermal injury.
Normally erythrocyte membranes fragment at temperatures >= 49°C. Spectrin denatures at these temperatures, making the membranes fragile to shear stress.
A patient with hereditary elliptocytosis may have one or more mutations in spectrin or other red blood cell membrane proteins. These abnormal proteins may denature at lower temperatures than normal erythrocytes. Mild forms may show RBC degeneration at 45-46°C while more severe forms may have RBC degeneration at 41°C.
where:
• A very high fever may be sufficient be a sufficient thermal stress.
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