Ammar Khojah, Talal Qadah
Abstract: Introduction Sickle cell anemia (SCA) is one of the common hematological disorders found worldwide. Determination of the difference between steady state and sickle cell crisis in term of coagulation and red cells parameters can help clinicians to assess patients condition and management. Methods A total number of 95 SCA patients were recruited in this study including 45 females and 50 males aged between 13 and 53 years old. These were divided into steady state and sickle crisis. Complete Blood Count and coagulation profile were performed to determine anemia status and assess the hypercoagulability status in steady state and sickle crisis. Results 50 (52 %) patients were diagnosed with crisis, while 45 (47 %) patients were found in steady state. Sickle cell crisis was more common in the age of 20 to 30 years (n=23, 24.21 %) than other age groups. No statistical significance was observed in coagulation and red cells profiles except in the red cell hemoglobin contents represented by MCH (P=0.04) and MCHC (P=0.004) between SCA with crisis and a steady state. Conclusion There was no statistical significance found in the coagulation profile between the two conditions. Hyperactivity of coagulation cascade cannot be ruled out and more laboratory tests such as D-dimers, proteins C and S measurements should be performed to confirm this finding. Our study concluded that the significant increase in MCH and MCHC may occur due to the release of endogenous iron from the broken hemoglobin giving a significant contribution to polymerization and crisis process.
Keywords: Sickle Cell Anemia, Coagulation profile, RBC parameters, sickle cell crisis, steady state