Uric Acid Concentration in Patients with Sickle Cell Anaemia Presenting with Vaso-Occlusive Crises in Uch, Ibadan

Abstract

Sickle cell anaemia is a point mutation characterized by homozygous inheritance of HbS, the commonest presenting symptoms in patients with sickle cell anaemia is vaso-occlusive bone pain crisis; this is an acute exacerbation of chronic inflammatory state in them. Elevated serum uric acid is associated with increased oxidative state, inflammation, hyperhaemolysis and sickle cell nephropathy in adult patients with sickle cell disease. There are inconsistence findings on uric acid concentration during vaso-occlusive pain crisis in patients with sickle cell disease. This study compares uric acid concentration in sickle cell disease patients with bone pain crisis, steady state and HbA individuals. It also correlates uric acid concentration with the severity of vaso-occlusive crisis in patients with sickle cell disease using bone pain crisis as a prototype of a vaso-occlusive crisis. Thirty each of sex and age-matched adult patients with sickle cell anaemia in a bone pain crisis, steady state and HbA were recruited in this study. Total summary pain score was used for assessment of bone pain crisis severity, 23 parameters automated haematology analyzer was used to measure haematological parameters. Plasma uric acid concentration was determined by Uricase method using the Landwind LWC 100 plus automated analyzer machine. Data obtained were analyzed using the Statistical Package for the Social Science (SPSS) version 20. Results were considered statistically significant if p<0.05. Biochemical parameters were correlated with the severity of bone pain crisis. Plasma uric acid concentration of mild BPC, moderate BPC and severe BPC were not significantly different from those of steady state group (p=0.523, 0.543 and 1.000 respectively) There was also no significant correlation in the mean plasma uric acid concentration in mild BPC, moderate BPC and severe BPC (Correlation coefficient (r)=0.212, p-value=0.372). In conclusion, this study established that though the uric acid concentration was higher in patients with SCA presenting with severe bone pains crisis than those with mild bone pain crisis and moderate bone pain crisis. However, there was no significant correlation between uric acid concentration and severity of bone pain crisis.