Haematological and Clinical Assessment of Steady State Homozygous Hb Sand Homozygous Hb A

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Haematological and Clinical Assessment of Steady State Homozygous Hb Sand Homozygous Hb A

Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 2

Abstract

Introduction:The abnormalities in patients with sickle cell anaemia (HbSS) result in multi- organ and systemic complications and clinical manifestations. The study aims at assessing and determining the correlates of the haematological and some clinical parameters in steady state adults with homozygous Hb S compared with adults with homogygous Hb A controls. Method: It is a cross-sectional study involving 83 subjects (58 patients and age- and sex-matched 25 Hb A controls).Patients aged 16 – 52 years with confirmed HbSS using cellulose acetate electrophoresis at pH8.4 in steady state and age and sex- matched HbAA apparently healthy controls were recruited. Patients were physically examined and vital signs, height, weight, size of the liver and spleen, Karnofsky performance scale, KPS (0-100%) and visual analogue scale VAS for well-being were obtained. Venous blood (4.5mls) was collected into an EDTA bottle for a full blood count (WBC, RBC, Hb, PCV, MCV, MCH, MCHC, RDW and platelet count). Data was analyzed using Excel and SPSS version 20 statistical package. Results: Patients with Hb SS had a significantly lower mean ± SD for visual analogue scale out of 10 (VAS; 8.4 ± 1.1); Karnofsky (85.8 ± 7.8%); Pulse rate (83.8 ± 11.9 beats/mm) and diastolic BP (64 ± 9.4 mmHg) than the controls (P < 0.01), but systolic BP was not significantly different from Hb AA controls (102.9 ± 10 mmHg and 106.6 ± 10.8 mmHg respectively; P> 0.05). Hepatomegaly (15.2%), splenomegaly (6.8%) and both (17.2%) were observed in patients with sickle cell anaemia only. Out of the nine parameters measured with the use of automated cell counter seven parameters: RBC, Hb, PCV, WBC, platelets, MCHC, and red cell distribution width (RDW) were observed to be significantly lower in patients than controls but MCV and MCH were not significantly different (P > 0.05). Thirty six (62%) patients had elevated WBC (i.e. >10 ± 10/L) while 11 (19%) patients had elevated platelet counts (i.e. > 400 ± 109 /L). Significant positive correlations were found between the red cell counts, Hb, haematocrit, SBP and DBP. While Hb and haematocrit correlated significantly with height and weight respectively. Weight and height also correlated significantly with SBP and DBP and furthermore WBC inversely correlated significantly with SBP and DBP (r = -0.314 and r = -0.303 respectively;P < 0.05). Conclusion:Persistent splenomegaly was not as common as hepatomegaly in patientswith Hb SSin this study,who were observed to have a relatively lower diastolic blood pressure, pulse rate and state of well-being than the Hb AA controls. Patients had higher values of MCHC, platelets and white blood cell counts and the red cell count, haemoglobin, haematocrit, weight and height had a positive relationship with blood pressure indices in patients only.

Authors and Affiliations

Uche CL, Akinola NO, Durosinmi MA

Keywords

EP ID EP592001
DOI 10.9790/0853-160203117122.
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