Evaluation of hemorheological Parameters Among Sickle Cell Anaemic Patients In Obafemi Awolowo University Teaching Hospital Complex Ile-Ife, Nigeria

ABSTRACT INTRODUCTION: Sickle cell disease (SCD) is a genetic disorder of the public health concern in many parts of the world, characterised by; Vaso-occlusive crisis AIM: To investigate the effects of hemorheological parameters as the probable cause of the recurrent Vaso-occlusive crisis (VOC) among some sickle cell anaemic patients. MATERIALS AND METHODS: A cross sectional laboratory-based study was adopted, a total of 120 samples were used, 60 of which were apparently healthy individual with genotype AA, remaining 60 were sickle cell anaemic subjects (SS), these were grouped into less frequent VOC and frequent VOC according to the number of hospital admission as a result of their VOC occurrence in a year. The history of VOC was taken from the case notes at Haematology Clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife Osun State, Nigeria. The samples were analysed for Packed Cell Volume (PCV), Erythrocyte Sedimentation Rate (ESR), Platelet count (PC), Whole Blood Viscosity (WBV), Plasma Viscosity (PV), Fibrinogen Concentration (PC). PCV and PC were determined using Sysmex XP 300 haematology auto analyser, WBV and PV by Reid and Ugwu method, plasma Fibrinogen by Clot and Weight method, ESR by modified Westergren method, at OAUTHC haematology laboratory, Ile-Ife. RESULTS: The results of this study revealed hemorheological Parameters to be statistically significant (P<0.05) in sickle cell patients when compared with the control group HbAA. The PCV was significantly reduced (22.57 ± 4.91) when compared with the values obtained in the control group (41.40 ± 4.33). Similar patterns of significance were observed when each sickle cell groups were compared with the control group. There was a marked reduction in the values of Platelets among frequent Vaso occlusive crisis (268500.00 ± 161157.42) when compared with less frequent Vaso-occlusive group (399634.62 ± 1922418.21). DISCUSSION: The study revealed some possible prognostic indices and preventive care plan against Vaso-occlusive crisis when significant parameters are properly and clinically applied. Haematocrit values (22.57 ± 4.91) for sickle cell patients were significantly decrease and statistically significant (P<0.05) when compared with control group (41.40 ± 4.33). There is observable statistically significant difference (P<0.05) in the ESR among the sickle cell patients when compared with the control group.       There was high WBC values among the sickle cell groups when compared with the control group with confirmed modest leucocytosis among the sickle cell patients, even at steady state, high platelets count is the usual findings among SCD was also observed in this study when compared with control group. Steady statistically significant differences (P<0.05) were observed in whole blood viscosity, plasma viscosity and plasma fibrinogen concentration among the sickle cell patients in Sickle cell groups  when compared with the control groups The high values in WBV, PV, Platelets and Fibrinogen concentration with concurrently low values in PCV may be the cause of recurrent VOC. CONCLUSION: It can be concluded from this study that, high values of Hemorheological parameters (WBC, PV, PC and FC) partly responsible for sickle cell crisis.