The influence of decreased levels of high density lipoprotein cholesterol on hematological indices in sickle cell disease patients

Background:

Changes in lipoproteins levels in sickle cell disease (SCD) patients are well-known, but the physiological ramifications of the low levels observed have not been entirely resolved.

Aim:

The aim of this study is to evaluate the impact of decreased levels of high density lipoprotein cholesterol (HDL-c) on hematological indices in steady state SCD patients.

Subjects and Methods:

The study was conducted on 84 SCD patients on steady clinical state, 36 males and 48 females with a mean age 21 (6) years. All those who have had blood transfusion within 4 months, infection, chronic kidney disease, and inflammatory episodes were excluded. Full blood count, total cholesterol, HDL-c, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, and triglyceride were assayed. Hematological indices of SCD patients with decreased levels of HDL-c were compared with those with normal HDL-c levels.

Results:

The SCD patients with decreased levels of HDL-c presented with lower levels of hemoglobin (P < 0.01), hematocrit (P < 0.001), total leukocyte count (P = 0.02), red blood cell count (P < 0.01), absolute neutrophil count (P = 0.04), absolute monocyte count (P < 0.01), and triglyceride (P = 0.02). Of the 47 SCD with decreased levels of HDL-c, 82.9% (39/47) have had blood transfusion while 48.6% (18/37) out of 37 SCD with normal HDL-c have had blood transfusion.

Conclusion:

SCD patients with decreased levels of HDL-c had more severe anemia, higher leukocyte and platelet counts than those with normal HDL-c levels. The low HDL-c marker may assist in the prediction of adverse clinical events in these patients.

Relationship between ABO blood group and ABH secretor status in Kano, north-western Nigeria

BACKGROUND

The determination of ABO Blood groups and ABH secretor status in blood and body fluid antigens respectively may have certain structural and disease related genetic linkages, hence the need to establish relationship between blood group and secretor status in the population.

METHOD

A total of 256 subjects comprised of blood donors and healthy pregnant women at Aminu Kano Teaching Hospital, Kano were studied. Their ABO Blood groups and secretor status were determined by standard tile/tube and haemaglutination inhibition methods respectively.

RESULTS

The result of this study shows that blood group B had the highest percentage ofsecretors (85.33%) followed by blood group AB (83.33%). Blood group O had a value of 64.18% while blood group A had the lowest prevalence of secretors of 61.9% in Kano metropolis.

CONCLUSION

Blood groups A and O have lower prevalence of secretors compared to blood group B and AB, in Kano metropolis. There is need for further study to identify risk predisposition of these groups to cancer of the stomach and duodenal ulcer disease respectively; as reported in other parts of the world.

Proteinuria among adult sickle cell anemia patients in Nigeria

BACKGROUND/OBJECTIVE

The life expectancy of patients with sickle cell anemia (SCA) has improved with modern medical care, and this has led to frequent observation of various chronic complications of the disease including abnormalities in renal function. Proteinuria is not only a marker of renal disease but is also a predictor of disease progression. This screening study was aimed at evaluating the prevalence of proteinuria among adult SCA patients in Kano, Nigeria, which has not been reported previously.

MATERIAL AND METHODS

A total of 200 adult SCA patients were studied. They consisted of 100 men and 100 women. Blood was collected for the assay of serum urea, sodium, potassium, chloride, bicarbonate, and creatinine and estimated glomerular filtration rate (eGFR) was determined using the Cockcroft-Gault formula. Urine dipstick test for the presence of proteinuria and other abnormalities was done, and 24-hour urine protein was measured in those with significant proteinuria.

RESULTS

Mean age of the male patients was 25.1 ± 1.0 years, whereas the mean age of the female patients was 22.8 ± 4.2 years. Twenty eight percent (32 males, 24 females) of the subjects were observed to have significant proteinuria. The mean estimated eGFR of the males was 88 ± 19.6 ml/min while that of the females was 92 ± 10.2 ml/min. The male SCA patients with proteinuria had a mean eGFR of 70 ± 6.9 ml/min, whereas the female SCA patients with proteinuria had mean eGFR of 101 ± 2.5 ml/min. Among the male patients with proteinuria, 50% had chronic kidney disease (CKD).

CONCLUSION

Proteinuria which is a marker of renal insufficiency is common among adult SCA patients, and routine screening for proteinuria may help detect those at increased risk of renal disease. CKD prevalence is high among SCA patients with significant proteinuria.