Some conventional and non-conventional hematological and biochemical markers for characterizing some acute and chronic presentations of sickle cell patients

Abstract

Background: Some acute and chronic presentations of sickle cell disease (SCD) are splenomegaly, acute chest syndrome (ACS), priapism and leg ulceration. Hematological and biochemical parameters are used for diagnosis and prognosis. Method: In this cross-sectional study, carried out over a 12-month period, involving 291 patients, some conventional hematological and biochemical parameters, and two nonconventional determinations, aspartate aminotranferase: alanine aminotransferase (AST:ALT) ratio and urine color, were used to characterize the patients with some selected clinical presentations. Results: For these subjects studied (n = 21), the mean values of hemoglobin (Hb), red blood cells (RBC), white blood cells, (WBC), reticulocytes, platelets and fetal hemoglobin (HbF) were 6.6 g/dl, 2.28×1012/L; 16.3 ×109/L, 27.1%, 310.1×109/L and 1.84%, respectively. The mean AST:ALT ratio was 2.058 and the urine color, 2.381. Thesevalues were compared to 5 non-anemic counterparts, who had the following mean values of the parameters; Hb = 11.9 g/dl; RBC = 4.13×1012/L WBC = 7.2×109/L; reticulocytes = 5.2%; platelets = 282.4×109/L; HbF = 1.48%. A Mann-Whitney non parametric two-tailed test showed several of the differences between the patients with complications and the non-anemic, were statistically significant (p < 0.05). The subjects with the complications were moderately anemic, having elevated levels of lactate dehydrogenase, total bilirubin, indirect bilirubin and AST:ALT ratio. Conclusion: The four clinical presentations were characterized by anemia, accompanied by high levels of conventional markers, like reticulocytes, lactate dehydrogenase (LDH) and bilirubin, together with an elevated AST:ALT ratio, a non-conventional marker.