Abstract
Recurrent bone pain or vaso-occlusive crisis (VOC) constitutes a major presentation in patients with sickle cell anaemia. This is partly attributable to vasospasm, oxidative stress and inflammation. Xanthine oxidase is released during VOC and it had been implicated in the pathogenesis of bone pain crisis in patients with sickle cell anaemia. This study was aimed at comparing the plasma levels of xanthine oxidase activity in adult patients with Sickle cell anaemia (SCA), during bone pain crisis (BPC) and steady state and correlating it with the severity of bone pain crisis. Thirty adult sickle cell anemia patients with BPC and 30 in steady state attending Haematology clinic at the University College Hospital, Ibadan, Nigeria and 30 normal haemoglobin A, age- and sex-matched controls were enrolled for this study. Severity of BPC was assessed with total summary pain score. Haematological parameters were determined by a 5-part autoanalyzer. Plasma xanthine oxidase activity was determined using enzyme linked immunosorbent assay (ELISA). 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 xanthine oxidase activity was significantly elevated in the BPC group than in the steady state group (p=0.000) and HbA group (p=0.000). There steady state group plasma xanthine oxidase activity was also significantly higher than that of HbA group (p-0.032). Similarly, the plasma Plasma xanthine oxidase activity was significantly higher in all BPC severity group than steady state group with associated significantly low positive correlation of xanthine oxidase activity and bone pain severity. This study established that plasma xanthine oxidase activity was higher in patients with SCA presenting in bone pain crisis than steady state and HbA individual with associated positive correlation between plasma xanthine oxidase activity and bone pain severity.
Highlights
Background of the study Sickle cell anaemia (SCA) is a type of sickle cell disease (SCD) that is characterized by homozygous inheritance of HbS
The clinical characteristics of the steady state and bone pain crisis groups showed that the mean age at diagnosis of SCA were 26 and 33 months respectively while the mean duration of last episode crisis prior to this study were 7.6 and 6 months respectively
This study showed a significantly higher plasma xanthine oxidase activity in patients with sickle cell anaemia in bone pain than patients with sickle cell anaemia in steady state and HbA controls
Summary
Background of the study Sickle cell anaemia (SCA) is a type of sickle cell disease (SCD) that is characterized by homozygous inheritance of HbS. This is the most common and most severe form of sickle cell disorder [1]. Patients suffer acute episodic crises and chronic complications resulting in substantial morbidity and early death. The most frequent morbidity in patient with SCA is episodic vaso-occlusive crises (VOC) which often present as bone pain crisis. The bone pain crisis severity is both objectively and subjectively measurable unlike VOC in Odebiyi Hassan Abiola and Fasola Foluke Atinuke: Xanthine Oxidase Activity in Patients with Sickle Cell Anaemia
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