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.
Highlights
Sickle cell anaemia (SCA) is the homozygous inheritance of haemoglobin S (HbS) [1]
This is a cross-sectional study on the uric acid concentration of 90 adult participants, The participants were divided into 30 each age and sex-matched sickle cell anaemia in bone pain crises (BPC), sickle cell anaemia in steady state (SS) and normal HbA control
When comparing the uric acid concentration in the three different severities of bone pain crisis among each other, there was no significant difference in the mean uric acid concentration among the mild BPC group, moderate BPC group and severe BPC group
Summary
Sickle cell anaemia (SCA) is the homozygous inheritance of haemoglobin S (HbS) [1]. It is the commonest monogenic disorder in the world with great impact in sub-Saharan Africa, in Nigeria [2, 3]. Inhibitor of platelet-endothelial cell adhesions and vascular smooth muscle proliferation such as nitric oxide production is reduced in the presence of uric acid [8]. All these culminate in increase oxidative stress that causes oxidative damage to the tissues and organs affected by the vasoocclusion. This subsequently induces an inflammatory reaction in the damaged tissues which further generates nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (another ROS) released by polymorphonuclear cell and monocytes. Plasma uric acid concentration in patients with sickle cell disease presenting with vasoocclusive crisis using (bone pain crisis as a prototype) and correlation of uric acid concentration with the severity of bone pain crisis was determined in this study
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