Haematological values in sickle cell anaemia in steady state and during vaso-occlusive crisis in Benin City, Nigeria

Abstract

Background: Sickle cell anaemia (SCA) is a major cause of morbidity and mortality in Africa where there is no readily available effective treatment. This study was designed to determine the haematological values that can be used in monitoring the status and management of SCA patients.

Method: A prospective study of 200 patients (81.3%) in steady state, 46 patients (18.7%) during vaso-occlusive crisis (VOC) and 84 control subjects seen between August 2001 and July 2002 in 3 centers in Benin City, Nigeria had their blood samples analyzed within two hours of collection. Automated Coulter Counter was used to determine the complete blood counts while the foetal haemoglobin (HbF) was estimated by the modified Betke method and haemoglobin A₂ by HbS-free microcolumn chromatography.

Results: The mean cell volume (MCV), mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC) in steady state were 79.38fl ± 22.41, 28.31pg ± 3.58 and 32.56g/dl ± 2.27 while in VOC they were 85.50fl ± 8.14, 28.79pg ± 2.78 and 33.76g/dl ± 3.44 respectively. The red cell distribution width (RDW), haemoglobin A₂ and F in steady state were 23.76% ± 6.49, 4.52%± 1.16 and 2.17% ± 1.81 while during VOC they were 21.62%5.11, 3.82%± 1.27 and 2.05% ± 1.19 respectively. The neutrophil count (P<0.01), MCV (P<0.01) and MCHC (P<0.05) were significantly higher during VOC than steady state while the RDW (P<0.05) and haemoglobin A₂ were significantly higher in steady state than during VOC.

Conclusion: Parameters, which are not usually reported in previous studies, have been shown in steady state and VOC.

Keywords: haematological values, sickle cell anaemia

Rsum

Introduction: La drpanocytose est la cause principale de la morbidit et mortalit en Afrique o il n\' y a aucun traitement efficace facilement dispobible. L\'objet de cette tude est de dterminer des valuers hmatologiques qu\'on pourrait utiliser dans la surveillance du statut et la prise en charge des patients atteints de la drpanocytose.

Mthode: Une tude potentielle compose de 200 patients soit 81,3% dans un tat normal, 46 patients soit 18,7% pendant la crise vasco-occlusive (VOC) et 84 sujets contles vus entre aot 2001 et juillet 2002 dans 3 centres la ville de Benin, Nigria avaient eu leur prise du sang analys en moins de deux heures de la collection Dcompte Coulter automatis tait utili pour dterminer le dcompte du sang total tandis que l\'hmoglobine foetale (hbF) tait value travers la chromatographie microcolumn libre HbS.

Rsultats: Le moyen du volume de la cellule (MVC), d\'hmoglobine cellulaire moyenne (HCM) et la concentration hmoglobine cellulaire moyenne (CHCM) dans un tat stable taient 79,38fl±22,41, 28,31pg ± 3,58 et 32,56/dl± 2,27 tandis que dans le VOC ils taient 85,50fl+- 8;14,28,79pg±33,76g/dl+- 3,44 respectivment. La largeur de la distribution du globule rouge (LDGR), hmoglobine A2 et F dans un tat stable taient 23,76 %±6.49,4,52%±1,16 et 2,17%±1,81 tandis que pendant le VOC ils taient 21,62%%±5,11, 3,82%±1,27 et 2,05%±1,19 respectivement, le dcompte neutrophil, (P<0,01), MVC (P<0,01) et CHCM (P<0,05) taient sensiblement trs lev pendant VOC que tait stable tandis que la LDGR (P<0,05) et hmoglobine A₂ taient sensiblement plus leve dans l\'tat stable plus que pendant VOC.

Conclusion: Des paramtres, qu\'on n\'avait pas rapport normalement dans des tudes prcdentes, ont t montrs dans l\'tat stable et VOC.

Mots cls: valuers hmatologiques, la drpanocytose

Annals of African Medicine Vol. 4(2) 2005: 6267