Acute liver insufficiency, followed by heart disease, pneumopathy and infectious syndrome is reported in a 36 year old brown alcoholic man in which the necropsy revealed anatomopathological changes suggesting sickle cell trait. Acute ischemic lesions were noted in the heart, kidneys, central nervous system and liver. In the absence of other causes explaining the ischemic lesions, they were attributed to circulatory changes related to sickle cell trait. Hepatic failure was consequent to functional disturbances derived from the occlusion of sinusoids and necrosis of hepatocytes. The factor responsible for sickling, which caused recent ischemic lesions, may have been the respiratory insufficiency secondary to lung disease. Chronic ischemic lesions have been seen in the heart and may be related to previous sickling episodes. Subsequent to necropsy findings, screening of family members revealed a daughter with sickle cell trait.