Abstract
Introduction: Sickle cell anaemia (SCA) is a lifelong
chronic haemolytic disorder with episodic acute
manifestations and chronic end organ damage. Serum
lactate dehydrogenase levels and reticulocyte count
are predictors of disease severity. This study
determined the serum lactate dehydrogenase (LDH)
levels in children with SCA in steady state and crisis;
and to correlate the serum LDH levels, reticulocyte
counts and haematological parameters.
Methods: Across-sectional study conducted over a
nine-month period, involving 212 children with SCA
(106 subjects in steady state and another 106 subjects
in crisis). Blood samples were taken from the subjects
in the two groups, full blood counts (Haematocrit,
leucocyte counts & differentials and platelet counts),
reticulocyte counts and serum lactate dehydrogenase
(LDH) levels done for each sample taken.
Results: There was no significant difference in the
mean age [8.0±4.3 vs 8.0± 4.0 years, p=0.67], Body
Mass Index [ 14.6 ±3.2 vs 15.6kg/m2, p=0.07], and
LDH levels [(740.0±270.3IU/L) vs (770.4±198IU/
L), p=0.323]] for crisis and steady states respectively
However, the mean reticulocyte count [0.59±0.48 vs
(0.98±0.62%/ p<0.001) was significantly lower in steady
state than in crisis state. In the crisis group, there were
positive correlations between serum LDH and total white
cell counts (r=0.14, p=0.05), serum LDH and platelet
count (r=0.03, p=0.747), serum LDH and reticulocyte
count (%) (r=0.11, p=0.26). There was a significant
negative correlation between serum LDH and
haemoglobin levels (r=-0.16, p=0.01).
Conclusion: Lactate dehydrogenase, a marker of
haemolysis, was elevated in both steady and crisis
states which further supports the fact that SCA is a
chronic haemolytic disorder. Increased reticulocytes
count as found in patients in crisis state is suggestive
of increased erythropoiesis as a response to the
pathology present in this clinical state. We
recommend routine reticulocytes count checks as a
measure to distinguish steady from crisis states.
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