Markers of hypercoagulation and chronic inflammation in sickle cell anemia of Yemeni patients: association with Vaso-occlusive crisis

Background Sickle cell anemia (SCA) is a hereditary hemoglobin (Hb) disorder, chronic hemolytic anemia, associated with a number of acute and chronic complications of Vaso-occlusive crisis (VOC). A high rate of VOC is an index of clinical severity that correlates with early death. Recent evidence implicates a state of chronic inflammation in the pathogenesis of SCA. Aim The aim was to determine the markers of hypercoagulation state and chronic inflammation in Yemeni SCA in steady state and VOC, in addition to their role in disease progression. Patients and methods This study was a comparative cross-sectional, carried out on 51 patients of SCA, age 1–28 years, 20 (39.2%) males and 31 (60.8%) females, were admitted into Yemen Society for Thalassemia and Genetic Blood Disorder in Sana’a Yemen, and 35 as control group. All participants were subjected to clinical examination and lab. Investigation includes: complete blood count, Hb electrophoresis, high-sensitivity C-reactive protein (hs-CRP) and D-dimer, prothrombin time (PT), and partial thromboplastin time (PTT). Results SCA in VOC were significantly higher for PT; PTT, white blood cell count, and Platelet count, while, significantly lower in Hb compared with control group, moreover was less significant compared with SCA in steady state. D-dimer was significantly increased in the steady state, compared with control group,nevertheless an approximate 2 fold increase in SCA in VOC. CRP was higher significant in steady state than controls, nevertheless was much higher in SCA in VOC, on the other hand, was significantly positive correlation between D-dimer and CRP patients with SCA in VOC only. Conclusion This study suggests the presence of hypercoagulable states and chronic inflammation in Yemeni SCA during steady state which is exacerbated during painful crises. A good discriminatory power for hs-CRP and D-dimer in VOC episodes of SCA, which can help predict the severity of VOC.