Uric Acid: A Biomarker for Vaso-Occlusive Crisis in Sickle Cell Anaemic Children?

Background: Sickle cell anaemia (SCA) is a genetic disorder that affects about 2-3% of the Nigerian population with an alarmingly high mortality rate in children. Uric acid, an oxidative stress and inflammation biomarker, has been implicated in complications arising in SCA during crises and steady states. Aim: This study aimed to investigate and compare uric acid levels, along with other biochemical and haematological parameters, in children with sickle cell anaemia during crisis and steady states. Methods: One hundred and fifty (150) children aged 2-18 years were recruited from the sickle cell clinic at Specialist Hospital, Sokoto, comprising 50 children in crisis, 50 in a steady state, and 50 apparently healthy controls. Five millimeters of blood samples were collected from the subjects to assess biochemical (uric acid, urea, creatinine), electrolytes and haematological parameters using standard techniques. Uric acid levels were measured using the uricase method, while urea and creatinine were analysed using the diacetyl monoxime and Jaffe’s method, respectively. Electrolytes (Na+, K+, Cl- and HCO3-) were analysed using an ion-selective electrode machine, and haematological parameters (haematocrit, white blood cell count, platelet count) were measured using a Sysmex haematology analyser. Results: There was no statistically significant difference in uric acid levels between SCA children during crisis and steady states compared to the control group (p>0.05). There were significant differences (p<0.05) in urea, creatinine, sodium, and potassium levels, but the values were all within reference ranges. Haematological parameters also showed significant differences, with lower haematocrit and higher white blood cell counts during the crisis state (p<0.05). Conclusion: This study found that uric acid levels do not significantly differ during crisis and steady states in SCA children, hence cannot serve as a biomarker in sickle cell children during vaso-occlusive crisis