Following are the findings in sickle cell Anemia, except –

Splenomegaly is found in the early stage of sickle cell anemia. By continued infarction and hypoxia - leads to progressive scaring and shrinkage of the spleen, so that by adolescent or adulthood, only a small nubbin of fibrous tissue may be left; this is called autosplenctomy. About other options Option 'a' Bone changes in sickle cell anemia are - Crew haircut appearance of skull bone Fish mouth vertebrae Option 'b' Cardiomegaly particularly increases in left ventricular dimension and mass results from an increase in cardiac output caused by chronic anaemia and has its onset in early childhood. Option 'd' The WBC count is consistently elevated owing to an increase in the number of mature granulocytes. This increase is explained to a large extent by a shift of granulocytes from the marginated to the circulating compartments.