Abstract

Comparison of clinical and urinary features of sickle cell disease patients having elevated leucocyte levels, with their counterparts with normal counts

Author(s): K.Nsiah

Objective The fact that leucocytes contribute to the disease process in SCD requires to be proven through various studies. In this study, it is hypothesized that in the mildly anemic SCD, the unfavorable effects due to either high or lowlevels of hemoglobin have been minimized, so how elevated levels of leucocytes affect the sickling pathobiology could be shown. Patients and method From a cross-sectional full blood count of SCD subjects, the mildly anemic group was selected, and this sub-group further stratified into two, based onWBC counts, a leucocytotic group, and the other with normal WBC count. Furthermore, the clinical and urinary features of the two groups were compared. Results Out of 241 mildly anemics, 150 of them; 79 males and 71 females were selected. Sixty six (66) of the selected mildly anemic showed leucocytosis. The SS male patients in crisis predominated the leucocytotic group (18/66 or 27.27%), and the mean leucocyte count of this group was 16.81 ×109/L. Clinically, apart from the vaso-occlusive pain, other features shown were fever, cough, splenomegaly, and respiratory tract infections. Additionally, the spot urine analysis showed the patients with leucocytosis had higher incidence of hematuria, proteinuria, bacteriuria and significant pyuria. Conclusion Despite the fact that the mildly anemic condition offers a less stressful hemodynamic condition in terms of hemoglobin levels, patients with elevated white cells, had poorer clinical and urinary features, an indication that probably, the inflammatory response elicited in these patients, might have gone berserk due to the high levels of the white cells.