Serum Copeptin and Cortisol Do Not Accurately Predict Sickle Cell Anaemia Vaso-Occlusive Crisis as C-Reactive Protein

Abstract

ObjectiveThis study assessed the diagnostic performance and prognostic properties of C-reactive protein (CRP), copeptin and cortisol in individuals with sickle cell anaemia (SCA).DesignProspective case-control studyMethodsSixty consecutive SCA subjects (18–40 years) comprising 30 subjects in the steady state and 30 subjects in vaso-occlusive crisis (VOC) were recruited into this study. Thirty (30) apparently healthy individuals with HbAA genotype served as controls. ELISA was used for the determination of serum levels of copeptin, CRP and cortisol. Data obtained were statistically analyzed using the Student’s t-test and Mann Whitney U as appropriate and P<0.05 was considered significant.ResultsSCA subjects in VOC had significantly lower copeptin level and significantly higher CRP level compared with controls. However, serum levels of copeptin, cortisol and CRP were significantly higher in SCA subjects in VOC compared with SCA subjects in steady state. Furthermore, CRP had the widest Area under the ROC curve (AUROC) than copeptin and cortisol. No significant difference was observed in the levels of copeptin, CRP and cortisol when SCA subjects in VOC who were hospitalized for less ≤5 days were compared with subjects who had longer stays.ConclusionIt could be concluded that C-reactive protein has a superior diagnostic performance for vaso-occlusive crisis in individuals with sickle cell anaemia and that C-reactive protein, cortisol and copeptin are not good prognostic markers in SCA subjects in vaso-occlusive crisis.

Defective lipid metabolism in sickle cell anaemia subjects in vaso-occlusive crisis

“…The interaction between SCA complications such as VOC and disturbed metabolic homeostasis in individuals with SCA has been reported 1419. In this study, TC and LDL decreased progressively from control-to-SSCA-to-VOC.…”

Very High Levels of C - Reactive Protein Should Alert the Clinician to the Development of Acute Chest Syndrome in Sickle Cell Patients

“…ACS has a multifactorial etiology, including a variety of inciting events that trigger deoxygenation of HbS, leading to its polymerization and to red blood cell sickling with subsequent vaso-occlusion, ischemia, and endothelial dysfunction (9,10). Heightened proinflammatory cytokine production has been reported in individuals with SCA during VOC (7). Elevated levels of CRP, a general marker of inflammation, have previously been reported in ACS patients with SCD (11)(12)(13)(14).…”

“…Previous studies have reported a strong association between increased CRP levels and VOC. The elevated CRP in SCD may be in response to endothelial damage due to the blockage of the vascular endothelium by sickled erythrocytes (6,7).…”

Prognostic Roles of C-Reactive Protein and Erythrocyte Sedimentation Rate As Acute Phase Reactants in Mentally Challenged Subjects

“…Laboratory investigations have linked mental problems with excessive stress. High cortisol levels reflect a higher degree of stress, but are dependent on the integrity of the HPA-axis [12]. Also, elevated plasma levels of arginine vasopressin (AVP) which is another stress hormone produced through HPA axis activity has been reported in schizophrenic patients [13].…”