Serum Zinc Level during and after Acute Painful Episodes in Children with Sickle Cell Anemia at the Aminu Kano Teaching Hospital, Kano, Northern Nigeria

Abstract

Background: Acute painful crisis due to vaso‑occlusive event is the leading cause of hospitalization in patients with sickle cell anemia (SCA). Zinc deficiency in children with SCA is associated with increased frequency and severity of acute painful events. We determined serum zinc level in children with SCA during acute painful crisis and compared the same with children with SCA who are in steady state and healthy non‑sickle cell disease children. Subjects and Methods: This was a descriptive longitudinal study, involving children with SCA age 6 months to 15 years at Aminu Kano Teaching Hospital, Kano, Northern Nigeria.

Subjects were recruited into three groups, which consisted of SCA in acute painful crisis, SCA in steady state, and normal subjects with hemoglobin AA (HbAA). A total of 210 subjects were recruited, 70 subjects each for SCA in acute painful crisis, SCA in steady state, and HbAA groups, respectively. Serum zinc was analyzed with atomic absorption spectrophotometery.  Serum zinc levels were repeated in children with SCA and acute painful crisis 4 weeks after resolution of painful events.

Results: The mean serum zinc level of SCA with acute painful crisis was higher than SCA in steady state, but the difference was not statistically significant (24.4 [11.0] and 23.4 [7.4]) µg/dL, respectively (t = 16.04, P = 0.54). While the HbAA control had significantly higher mean serum zinc level than SCA groups, both in acute painful and in steady state (F = 59.3, P = 0.001). Among children with SCA and acute painful crisis, repeat serum zinc level 4 weeks after resolution of acute painful events was significantly higher than during pain crisis (t = 64, P = 0.001).

Conclusion: Zinc deficiency occurs in children with SCA and the deficiency is worsened by acute painful events Therefore, it is recommended that zinc level should be assessed and any deficiency treated. Supplementation of
zinc should also be enhanced as this may reduce painful crisis in SCA.

Keywords: Acute painful crisis, sickle cell anemia, zinc