Up‐regulation of miR‐130a is related to leg ulcers in sickle cell anaemia

Evaluation Of Some Markers Of Haemolysis – Endothelial Dysfunction And Haematological Parameters In People With Sickle Cell Disease Leg Ulcers

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.229 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S104-S105

Author(s):

O E Otokiti ◽

G M Bassey

Keyword(s):

Nitric Oxide ◽

Endothelial Dysfunction ◽

Sickle Cell ◽

Sickle Cell Anaemia ◽

Statistical Significance ◽

Age Distribution ◽

Leg Ulcer ◽

Haematological Parameters ◽

Leg Ulcers ◽

Significant Difference

Abstract Introduction/Objective Sickle cell leg ulcer (SCLU) is one of the commonest cutaneous manifestation of the sickle cell anaemia (SCA). This study was designed to evaluate the haematological parameters and contribution of haemolysis to leg ulcers in persons with sickle cell anaemia Methods A comparative cross-sectional study of 73 participants (24 sickle cell leg ulcer-SCLU, 24 sickle cell without leg ulcer-SCWLU and 25 healthy controls). Physical examination was conducted to grade the SCLU. ELISA kits were used to analyse Nitric oxide, while FBC, Reticulocyte count, liver function test (AST and ALT), total Bilirubin (unconjugated and conjugated) were determined using standard methods. ANOVA was used to compare the association between sickle cell leg ulcers and markers of haemolysis-endothelial dysfunction among the three groups. Probability score of less than 5% (p-values<0.05) was considered statistically significant Results There was no statistically significant difference in the age distribution of the participants in this study. Those with SCLU were diagnosed at an older age and majority (52.2%) had clinical stage 2 leg ulcer. Among the markers for haemolysis-endothelial dysfunction (HED); Reticulocyte production index (PRI) was lower in SCLU (1.87 + 0.72) compared to SCWLU, (2.04 + 0.78) p= 0.01. Total and unconjugated bilirubin (µmol/L) level was higher for SCLU (53.0 + 17) in comparison to SCWLU (42.2 + 8.2) with statistical significance of p=0.00. Aspartate and alanine transaminases (AST and ALT) (U/L) were higher in SCLU in comparison with SCWLU, (60.1 + 21.5, 43.8 + 15.8 and 30.1 + 13, 29.8 + 11.7) respectively, and was statistically significant p= 0.00. However Nitric oxide was not statistically different between SCLU and SCWLU mean ± SD (49.57 + 12 and 46.19 + 9) respectively. p = 0.35 Conclusion Markers of haemolysis were higher in participants with sickle cell leg ulcer (SCLU) when compared to those without leg ulcer (SCWLU). However, no statistically significant difference was obtained for Nitric oxide (NO) between the two groups. Therefore, markers of haemolysis cannot be used as an effective predictor for risk of developing SCLU but early diagnosis of SCA can prevent SCLU.

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Topical sodium nitrite for chronic leg ulcers in patients with sickle cell anaemia: a phase 1 dose-finding safety and tolerability trial

The Lancet Haematology ◽

10.1016/s2352-3026(14)00019-2 ◽

2014 ◽

Vol 1 (3) ◽

pp. e95-e103 ◽

Cited By ~ 23

Author(s):

Caterina P Minniti ◽

Alexander M Gorbach ◽

Dihua Xu ◽

Yuen Yi Hon ◽

Kara-Marie Delaney ◽

...

Keyword(s):

Sickle Cell ◽

Sodium Nitrite ◽

Sickle Cell Anaemia ◽

Phase 1 ◽

Dose Finding ◽

Leg Ulcers ◽

Chronic Leg Ulcers

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Enhanced Hypercoagulability in Sickle Cell Anaemia Patients with Chronic Leg Ulcers

Advances in Hematology ◽

10.1155/2020/5157031 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

David Sackey ◽

Yvonne Dei-Adomakoh ◽

Edeghonghon Olayemi

Keyword(s):

Sickle Cell ◽

Sickle Cell Anaemia ◽

Antiplatelet Agents ◽

Organ Damage ◽

Leg Ulcers ◽

Chronic Complications ◽

The Mean ◽

Hb Concentration ◽

Chronic Leg Ulcers

Sickle Cell Anaemia (SCA) is associated with a hypercoagulable state resulting in a predisposition to venous thromboembolism. With improvements in the quality of care, more patients with SCA survive into adulthood with an associated increase in the frequency of end-organ damage and chronic complications such as chronic leg ulcers (CLUs). These ulcers rarely occur in the first decade of life and are recurrent, painful, and slow-to-heal. This study tested the hypothesis that coagulation is enhanced in SCA patients with CLU. 145 participants (50 SCA with CLU, 50 SCA without CLU, and 45 with haemoglobin AA) were assessed to determine their coagulation profile using selected tests of coagulation. The SCA with the CLU group had the lowest mean haemoglobin (Hb) concentration. SCA patients with and without CLUs had elevated mean platelet counts, shorter mean aPTT, and marginally prolonged mean PT compared to HbAA patients. SCA with CLUs patients had a significantly shortened aPTT than those without CLUs ( p = 0.035) and HbAA ( p = 0.009). There were significant differences in the mean PT between SCA with CLUs patients and HbAA ( p = 0.017); SCA without CLU and HbAA ( p = 0.014). SCA with and without CLUs patients had higher mean D-dimer levels compared to HbAA. There was a negative correlation between Hb concentration and duration of CLU (r = -0.331, p = 0.021). In conclusion, our study demonstrates a heightened hypercoagulability in SCA patients with CLUs. We did not test for platelet activation, and it is not clear what role, if any, the enhanced hypercoagulability plays in the pathogenesis of CLUs in SCA. It will be useful to ascertain if antiplatelet agents or/and anticoagulants quicken the healing of CLUs in SCA patients.

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