Which of the following is a symptom of sickle cell disease?

Sickle cell disease is a genetic blood disorder characterized by the production of abnormal hemoglobin, which can lead to various complications. One significant complication associated with this condition is the formation of gallstones. This happens because patients with sickle cell disease often have hemolytic anemia, meaning their red blood cells break down more rapidly than normal. The breakdown of red blood cells leads to increased levels of bilirubin, which can subsequently result in the formation of pigment gallstones.

Other options presented, such as hypertension, respiratory distress, and elevated white blood cell count, while they may occur in individuals with sickle cell disease, are not direct symptoms tied specifically to the disease itself. Hypertension can occur due to various reasons unrelated to sickle cell disease, respiratory distress can arise from numerous conditions, and an elevated white blood cell count might be present due to infections or stress reactions rather than being a defining symptom of sickle cell disease. Thus, gallstones are uniquely related to the hemolytic process in sickle cell disease, making that choice the most accurate symptom linked to the condition.