Sickle cell disease: Assessment of hemostasis parameters in steady-state patients at Tertiary Care Hospital, Indore, India

Abstract

Background: The evidence from various studies showed that patients with sickle cell disease (SCD) have altered components of hemostasis such as platelet function, procoagulant, anticoagulant and fibrinolytic pathways, and modulate inflammation such as acute or chronic inflammatory state. These components may alter based on race, regions, or environment. Assessment of the hemostatic parameters in our region is imperative because the altered components so involved may give an insight as to the clinical phenotypes of Arab-Indian haplotypes we have in our setting. The objective of present study is to assess basic hemostatic and inflammatory parameters in patients with SCD during steady state at a tertiary care hospital. Methods: Blood samples of 95 patients with SCD during steady state attending M. Y. Hospital, Indore, India, during the period of November 2019 to March 2020 were screened for C-reactive protein (CRP) levels and platelet counts using latex enhanced immune-turbidimetric assay and hemotology analyzer, respectively, while prothrombin time (PT) and activated partial thromboplastin time (APTT) by automated coagulation analyzer. Results: It was observed that there is no significant difference among the mean platelet count (321.9 ± 97.63 × 109/l) of SCD patients and control groups (P = 0.69). CRP levels (6.60 ± 2.83 mg/l) were found to be significantly increased (P < 0.01) in SCD patients in comparison with their respective control. The mean PT (15.21 ± 1.58 s) and APTT values (37.69 ± 2.50 s) were found to be significantly increased (P < 0.05 for both) in SCD patient group when compared with control group. Conclusion: The study confirms that patients with SCD in steady state have significant prolonged coagulation indices. These can be an evidence of hypercoagulable state in SCD and may provide reference values appropriate for therapeutic target. We recommend that patients of SCD especially those with severe vaso-occlusive crises should have these hemostatic parameters as a basic test and during routine clinic follow-up for improved management.