Although HU significantly improves most hematological parameters, the levels of inflammatory cytokines (tumor necrosis factor alpha and interleukin-6) and the NLR in patients with SCD do not reach values similar to those in healthy controls.(8) Therefore, despite receiving HU, patient 1's inflammatory state, associated with other conditions, could have been related to the occurrence of AIHA. The gene discussed is TNF; the disease is autoimmune hemolytic anemia.