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Kahema SE, Mbulwa CH, Bagenda CN, Niyonzima N, Muwanguzi E, Mcharo TL. Association between fetal hemoglobin, lactate dehydrogenase, and disease severity in patients with sickle cell disease at Bugando Medical Centre, Mwanza, Tanzania. PLoS One 2024; 19:e0286891. [PMID: 39008448 PMCID: PMC11249230 DOI: 10.1371/journal.pone.0286891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 06/12/2024] [Indexed: 07/17/2024] Open
Abstract
INTRODUCTION There is a wide range of clinical manifestations in sickle cell disease (SCD). Despite having the same condition, each person's response to disease complications differs greatly. Individuals can be categorized according to the severity of their diseases to determine which group they fall into and receive the appropriate care based on their needs. The relationship between fetal hemoglobin (HbF), lactate dehydrogenase (LDH), and disease severity in Tanzania is little understood. This investigation sought to ascertain the relationship between HbF, LDH, and disease severity in SCD patients at the Bugando Medical Center. METHOD This cross-sectional study was carried out on SCD patients aged 6 months and older at the Bugando Medical Center in Mwanza, Tanzania. A total of 130 SCD patients were enrolled. The clinical history and laboratory test results for SCD patients were recorded on a specially constructed patient report form. RESULTS The majority of participants (56.9%) were men. For the population under study, more than half (60.8%) of participants had a moderate clinical phenotype (MCP), followed by 31.5% of asymptomatic participants and 7.7% of people with severe clinical phenotypes (SCP). Participants with SCP had substantially higher levels of LDH, with a mean level of 810.97IU/L (95% CI: 559.31-1062.64) and a p-value of 0.005. The severe clinical phenotype exhibited a significantly higher mean HbF score value of 10.09% (95% CI: 7.44-13.74%) with a p-value of 0.024 when compared to the asymptomatic and moderate clinical phenotypes. CONCLUSION In SCD patients with SCP compared to ACP and MCP, the HbF levels were higher, but did not show a protective effects, and LDH can be used to predict the severity of SCD.
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Affiliation(s)
- Samwel Edward Kahema
- Mbarara University of Science and Technology, Mbarara, Uganda
- Morogoro College of Health and Allied Sciences, Morogoro, Tanzania
| | | | | | | | - Enoch Muwanguzi
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Tunzo L Mcharo
- Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
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Babalola OA, Ogunkeyede A, Odetunde AB, Fasola F, Oni AA, Babalola CP, Falusi AG. Haematological indices of sickle cell patients with chronic leg ulcers on compression therapy. Afr J Lab Med 2020; 9:1037. [PMID: 33392050 PMCID: PMC7756931 DOI: 10.4102/ajlm.v9i1.1037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/23/2020] [Indexed: 11/01/2022] Open
Abstract
Background Recurrent chronic leg ulcers and its are morbidities associated with sickle cell anaemia (SCA). Compression therapy increases the rate of healing of these ulcers and also decreases the rate of recurrence. Objective This study evaluated the haematological parameters of patients with SCA and chronic leg ulcers placed on high compression bandaging to provide data for improved ulcer management and prevention. Methods Eighteen patients with SCA and chronic leg ulcers were recruited for treatment by compression therapy in Ibadan, Nigeria, from March to June 2015. Eighteen SCA patients with no history of chronic leg ulcers were age and sex matched and recruited as controls. Blood samples, wound biopsies and swabs were collected at different time points for full blood count, microbiology, culture and antimicrobial susceptibility tests. Haemoglobin variants were quantified by high performance liquid chromatography. Fasting blood sugar was tested for leg ulcer patients to determine diabetic status. Results Ulcers ranged from 0.5 cm2 to 416 cm2 (median: 38.4 cm2). Post-intervention ulcer size ranged from 0.0 cm2 to 272 cm2 (median: 18.6 cm2, p < 0.001); four ulcers completely healed. Compared to the control group, haematological indices at commencement of treatment were more severe in leg ulcer patients (p = 0.02). No patients with chronic leg ulcer was diabetic. Microorganisms isolated from the leg ulcers include Pseudomonas aeruginosa, Staphylococcus aureus, Proteus sp., Escherichia coli and Klebsiella oxytoca. Conclusion Measures to improve haematological parameters during leg ulcer treatment in SCA patients should be taken to aid wound healing.
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Affiliation(s)
- Oluwatoyin A Babalola
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayodele Ogunkeyede
- Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Abayomi B Odetunde
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Foluke Fasola
- Department of Haematology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Anthony A Oni
- Department of Medical Microbiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Chinedum P Babalola
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Sickle Cell Hope Alive Foundation (SCHAF), Nigeria
| | - Adeyinka G Falusi
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Sickle Cell Hope Alive Foundation (SCHAF), Nigeria
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Jit BP, Mohanty PK, Purohit P, Das K, Patel S, Meher S, Mohanty JR, Sinha S, Behera RK, Das P. Association of fetal hemoglobin level with frequency of acute pain episodes in sickle cell disease (HbS-only phenotype) patients. Blood Cells Mol Dis 2018; 75:30-34. [PMID: 30597429 DOI: 10.1016/j.bcmd.2018.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is a Mendelian single gene disorder with highly variable phenotypic expression. In the present study, we analyzed the influence of HbF, alpha thalassemia and other hematological indices to determine their association with acute pain episodes. METHOD This case control study consisted of SCD subjects with HbS phenotype experiencing three or more acute pain episodes in last twelve months (cases) and without any episode of acute pain during last twelve months (controls). Hematological parameters, HbF, and presence of alpha thalassemia were assessed in all subjects. RESULTS A statistically significant difference between HbF levels (P < 0.025, χ2 test) and alpha thalassemia (P < 0.008, χ2 test) was observed between controls and cases group. Univariate analysis indicated that increased HbF levels > 25% (OR: 0.37, 95% CI: 0.18-0.77, P < 0.008) and presence of alpha thalassemia (OR: 0.53, 95% CI: 0.33-0.85, P < 0.009) provided protection, while multivariate analysis revealed significant protection was attributable only by higher HbF levels (OR: 0.39, 95% CI: 0.17-0.88, P < 0.025). Significantly higher HbF levels were observed only in the 11-20 age group of cases in comparison to controls (Student's t-test, P < 0.001). CONCLUSION Higher concentrations of HbF are associated with protection against frequent episodes of acute pain crisis in SCD patients.
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Affiliation(s)
- Bimal Prasad Jit
- School of Life Sciences, AIPH University, Bhubaneswar, Odisha, India; Sickle Cell Clinic and Molecular Biology Laboratory, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India
| | - Pradeep Kumar Mohanty
- Sickle Cell Clinic and Molecular Biology Laboratory, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India; Department of Medicine, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India
| | - Prasanta Purohit
- Sickle Cell Clinic and Molecular Biology Laboratory, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India; Multidisciplinary Research Unit, Maharaja Krishna Chandra Gajapati Medical College, Berhampur, Odisha, India
| | - Kishalaya Das
- Sickle Cell Clinic and Molecular Biology Laboratory, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India
| | - Siris Patel
- Sickle Cell Clinic and Molecular Biology Laboratory, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India
| | - Satyabrata Meher
- Sickle Cell Clinic and Molecular Biology Laboratory, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India
| | | | - Shalini Sinha
- School of Life Sciences, AIPH University, Bhubaneswar, Odisha, India
| | - Rajendra Kumar Behera
- School of Life Sciences, Sambalpur University, Jyoti Vihar, Burla, Sambalpur, Odisha, India
| | - Padmalaya Das
- School of Life Sciences, AIPH University, Bhubaneswar, Odisha, India.
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Chaudhari H, Goyal S, Patil C. Neonates with sickle cell disease are vulnerable to blue light phototherapy-induced oxidative stress and proinflammatory cytokine elevations. Med Hypotheses 2016; 96:78-82. [PMID: 27959283 DOI: 10.1016/j.mehy.2016.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 09/27/2016] [Indexed: 11/24/2022]
Abstract
Sickle cell disease is a frequent genetic anomaly characterized by altered molecular structure of hemoglobin resulting into crescent-like deformation of the red blood corpuscles. Neonatal jaundice is a frequent co-morbidity in sickle cell disease. Phototherapy induces isomerization of bilirubin rendering it extractable through urine and hence it is used as a routine treatment of neonatal jaundice. An exposure to light phototherapy as a treatment of neonatal jaundice induces oxidative stress. It is hypothesized that such exposure of neonates with sickle cell disease to the blue light phototherapy as a treatment of neonatal jaundice induces severe oxidative stress and increases the levels of proinflammatory cytokines. This hypothesis is supported with two case studies of sickle cell disease suffering neonates who were exposed to blue light phototherapy to treat jaundice. In both these cases, exposure to phototherapy induced oxidative stress (increased lipid peroxidation and superoxide dismutase, slight change in activity of catalase and GSH) and elevated the levels of proinflammatory cytokine (TNFα, IL-1, and IL-6) in the sickle cell disease suffering neonates. These observations warrant further investigations to determine the consequences and clinical significance of the blue phototherapy-induced oxidative and proinflammatory stress in Sickle cell disease suffering neonates exposed to phototherapy as a treatment of jaundice.
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Affiliation(s)
- Hemakshi Chaudhari
- Department of Clinical Pharmacy, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dist - Dhulia, Maharashtra, India
| | - Sameer Goyal
- Department of Pharmacology, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dist- Dhulia, Maharashtra, India
| | - Chandragouda Patil
- Department of Pharmacology, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dist- Dhulia, Maharashtra, India.
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