In sickle-cell disease it typically occurs after 6 months of age (as in infants protective fetal hemoglobin, HbF, is replaced with adult hemoglobin and the disease manifests) and is often the first clinical presentation of the disorder.[3]
^Robbins, Stanley Leonard; Kumar, Vinay; Abbas, Abdul K.; Cotran, Ramzi S.; Fausto, Nelson (2010). "Robbins and Cotran pathologic basis of disease". In Vinay Kumar, Abul K. Abbas, Nelson Fausto. Robbins Pathology Series (Elsevier). p. 205. ISBN978-1-4160-3121-5.