Quantification of Sickle Cells in the Peripheral Smear as a Marker of Disease Severity in Sickle Cell Disease in Paediatric Patients

Abstract

Background: Sickle cells are easily identified on the peripheral smear however quantification of sickle cells is seldom done. This study attempts to understand the importance of the sickling index in the reporting of peripheral smear in patients with SCD. Objectives: This study aims to standardize the methodology of quantification of sickle cells on the peripheral smear in paediatric SCD cases and study its relation to the patient characteristics like age and sex, SCD genotype, and treatment. Materials and Methods: A prospective study of 6 months duration was conducted at a tertiary paediatric referral hospital for 6 months. 30 known cases of SCD were admitted during this period. Routinely studied peripheral smears were used in the study. 30 normal smears of age-matched patients were also used for comparative purpose. The sickling index was calculated in both patient and age matched smears. The sickling index was compared in both the groups and also the index in the known SCD cases was studied in relation to the patient's age, SCD genotype, and treatment with blood transfusions or hydroxyurea. Statistical analysis: Descriptive statistics were used in the study Results & Conclusion: Hb SS was the commonest genotype seen in 69% of the cases. Higher sickling index was noted in older children, SS genotype and those on treatment with blood transfusions or Hydroxyurea. Sickling index is an interesting prospect which may provide helpful information regarding cases with increasing hemolysis and vasocclusive crises and also help in follow up of patients on treatment. Keywords: Paediatric, Disease severity, Sickling index