BackgroundRenal failure is common among older patients with sickle cell disease; this is
preceded by subclinical glomerular hyperfiltration. Data about renal function of
adults with sickle cell disease have been reported, but data on children is
scarce, especially when comparing heterozygotic and homozygotic patients. ObjectiveThe goal of this study was to investigate the glomerular filtration rate of
heterozygotic and homozygotic children with sickle cell disease. MethodsThe glomerular filtration rate of 11 children with sickle cell disease [7
homozygotic (SS) and 4 heterozygotic (SC)] with a mean age of 11 years (standard
deviation: ± 5 years) was evaluated using standard laboratory techniques. Results
are presented as descriptive analysis. ResultsOur results suggest that glomerular hyperfiltration is present in children with
sickle cell disease; this is more evident in homozygotic than heterozygotic
children. ConclusionThere is evidence of a need to monitor the renal function of children with sickle
cell disease when special attention should be paid to homozygotic patients.
Sickle cell disease shows several clinical manifestations in distinct levels of severity. This heterogeneity is due to the haplotype variability associated with the HbS gene, levels of fetal hemoglobin and environmental conditions, which modify the disease expression. Science community believes that the presence of a polymorphism in the CCR5 gene, which is related to chronic inflammatory state, could confer a higher survival rate and a lower number of inflammatory events to these patients since the deletion in CCR5Δ32 would knock out the CCR5 gene. Therefore, this study aimed to identify the haplotypes in β and β genes, as well as to investigate the presence of the CCR5Δ32 deletion in patients with sickle cell disease. For this purpose, DNA was isolated with the QIAamp DNA Investigator Kit, and PCR was the method chosen to detect the mutant allele CCR5Δ32. The haplotypes in β and β genes were detected by RFLP with the restriction enzymes XmnI, HindIII, HincII, and HinfI analyzing six polymorphic sites on the β cluster, succeeded by electrophoresis. The atypical haplotype was the most common (54.3%), followed by Benin (28.6%), Bantu (11.5%), Senegal (2.8%), and Cameroon (2.8%). No patients presented CCR5Δ32 deletion. The increase in the frequency of atypical haplotypes suggests that these patients passed by variation in the genetic pattern from ancestral haplotypes throughout the years.
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