Biochemical assessment of liver in sickle cell disease patients at a tertiary care hospital of north India

Tripathi, Pankaj; Tripathi, Manju

doi:10.18203/2320-6012.ijrms20151539

Cited by 6 publications

(9 citation statements)

References 10 publications

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“…Zinc deficiency is reported to be common in the general population of most low-income countries [ 22 ] and this may explain the insignificant difference between the SCA study population and the control. Significant increase in bilirubin and ALP levels in patients with SCA was demonstrated in the current study, similar to reports by a previous study [ 23 ]. Hepatic infarction due to sinusoidal obstruction by sickled red cells, intra-hepatic sequestration, cholelithiasis, transfusion-associated iron overload, viral hepatitis, and chronic haemolysis are implicated in SCA hepatopathy [ 9 , 24 ].…”

Section: Discussionsupporting

confidence: 92%

Micronutrient levels and haemato-biochemical status of patients with sickle cell anaemia at a tertiary hospital in Abakaliki, south-eastern Nigeria: a cross-sectional study

Nnachi¹,

Orih²,

Edenya³

et al. 2022

Pan Afr Med J

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Introduction nutritional status is an under-studied environmental factor that can impact the phenotypic manifestations of patients with Sickle Cell Anaemia (SCA). This study aimed to define hemato-biochemical parameters and micronutrient status in patients with SCA. Methods this was a cross-sectional study of patients with SCA and hemoglobin genotype HBAA controls at a tertiary health facility in Abakaliki, from 2 nd December 2020 to 31 st March 2021. Plasma micronutrient levels, haemato-biochemical parameters were analyzed and anthropometric measurements obtained from all participants. Results sixty participants with SCA had 58.3% females (mean age of 24.77±7.39 years) while controls had 50% females (mean age of 26.23 ± 8.44 years). The SCA group had significantly lowered calcium (2.733 ± 1.593 vs 1.846 ± 1.123 mmol/l; p=0.009) and magnesium (19.38 ± 6.37 vs 9.65 ± 1.38 mg/dl; p= < 0.001) levels but higher plasma iron (1.70 ± 0.89 vs 1.06 ± 0.53; p=0.001). Zinc and Copper did not reveal significant differences between the two groups. Chloride ion levels was significantly lower in the SCA patients (107.50 ± 17.42 vs 100.19 ± 12.92; p=0.026) while Alkaline phosphatase (ALP), bilirubin, total white blood cell (WBC) and platelets (PLT) count were higher compared with the HBAA group (255.72 ± 124.52 vs 134.56 ± 39.67; p= <0.001, 46.86 ± 25.03 vs 25.63 ± 18.80; p = 0.001, 13.21± 6.57 vs 6.10 ± 1.35; p= < 0.001 and 369.25 ± 138.11 vs 209.36 ± 47.85; p= <0.001). Conclusion Copper and zinc deficiency was not present in our population of SCA patients but, they had lower plasma calcium and magnesium levels and elevated levels of blilirubin, ALP, WBC and platelets PLT counts. These parameters can be explored in designing better management for patients with SCA

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Section: Discussionsupporting

confidence: 92%

Micronutrient levels and haemato-biochemical status of patients with sickle cell anaemia at a tertiary hospital in Abakaliki, south-eastern Nigeria: a cross-sectional study

Nnachi¹,

Orih²,

Edenya³

et al. 2022

Pan Afr Med J

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“…De Ritis ratio which is used to determine hepatic necrosis was observed to be of no statistical significance; this could be due to haemolysis. This was similar to the reports from previous studies [24,25,26] and somewhat similar to the findings by Akuyam et al but was at variance with previous studies reported but which shows that AST/ALT ratio was lower in adult compared to children [21]. However, De ritis ratio was higher in the patients than in the control.…”

Section: Discussionsupporting

confidence: 92%

Biochemical Assessment of the Liver in SCD in a Tertiary Hospital in South-South, Nigeria

Akaba

Enang

Bassey

et al. 2019

JAMMR

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Background: Sickle cell disease (SCD) is often associated with liver disease. The constant state of haemolysis, multiple blood transfusion, viral hepatitis, hepatic sinusoidal congestion, haemosiderosis and cholestasis, are all conditions which may eventually evolve into liver disease. Sickle cell disease is a heterogeneous group of disorders that is usually associated with an autosomal recessive structural haemoglobin disorder. Biochemical abnormalities have been associated with SCD and it is usually more pronounced in vaso occlusive crises; an acute bone crisis and common painful complication of SCD, than in steady state. Aim: The aim of the study was to assess some biochemical parameters in relation to SCD patients in our environment with a view to improving the monitoring and management of these patients. Methodology: The study was a comparative hospital based research carried out at the University of Calabar Teaching Hospital (UCTH), Calabar, South-South Nigeria. Liver function tests were carried out on 60 SCA both in steady state and in crisis and also on 50 apparently healthy adults. The data collected were analyzed using statistical data for social sciences (SPSS) Version 22 for windows. Pearson linear correlation and simple inferential statistical methods were employed for data analysis, a P ≤ 0.05 was considered to be statistically significant. Result: The serum concentrations of AST, ALT, ALP, LDH, Total and conjugated bilirubin were seen to be elevated in VOC compared to in steady state and with the apparently healthy control group. The AST/ALT ratio was also observed to be elevated in VOC as compared with the steady state and the control. Significant product moment correlation was observed in the biochemical parameters both in steady state and in VOC. Conclusion: The findings of this study revealed marked changes in the biochemical parameters of the liver in VOC than in steady state. It will be recommended that routine evaluation and proper interpretation of liver enzymes is paramount in early detection of liver pathology in SCD.

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“…In case of acute liver disease, usually PT is increased, but APTT may be found to be normal. APTT is usually increased in chronic liver diseases 22 36 . This finding matches with our study, as in our study PT was significantly increased in seizure group but APTT did not increase significantly.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Clinical Seizures in Neonates with Hypoxic–ischemic Encephalopathy Treated with Therapeutic Hypothermia

et al. 2022

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Background This study aimed to assess the risk factors for clinical seizures in newborns treated with whole body cooling (WBC) for hypoxic ischemic encephalopathy (HIE). Methods Infants with gestational age≥36 weeks and birth weight≥2.000 g who were treated with WBC due to HIE were retrospectively enrolled in this study. Patients were assigned to two groups: infants without clinical seizures (Group 1) and infants with clinical seizures (Group 2). The two groups were compared to determine the risk factors for the occurrence of clinical seizures. Results A total of 25 patients (Group 1=10 and Group 2=15) were included in the study. Prothrombin time (PT) was determined as independent risk factor for clinical seizures (p=0.046) and the odds ratio for the effect of PT was found as 1.475 (%95 CI:1.006–2.299). PT (area under the curve [AUC]=0.764; p=0.041), and increased cardiac troponin-I (cTnI) (AUC=0.935; p=0.002) were found to be significant risk factors for predicting the occurrence of clinical seizures. The optimal PT cut-off value was 22.7 sec, with a sensitivity and specificity of 45.4% and 90%, respectively; as well as positive and negative predictive value of 83.3% and 60.0%, respectively. The chest compression in the delivery room, severely abnormal amplitude integrated electroencephalography and high encephalopathy score were also found risk factors for occurrence of clinical seizures. Conclusion Chest compression in the delivery room, high encephalopathy score, prolonged PT, and increased cTnI are significant factors for clinical seizures in newborns treated with WBC for HIE.

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Biochemical assessment of liver in sickle cell disease patients at a tertiary care hospital of north India

Cited by 6 publications

References 10 publications

Micronutrient levels and haemato-biochemical status of patients with sickle cell anaemia at a tertiary hospital in Abakaliki, south-eastern Nigeria: a cross-sectional study

Micronutrient levels and haemato-biochemical status of patients with sickle cell anaemia at a tertiary hospital in Abakaliki, south-eastern Nigeria: a cross-sectional study

Biochemical Assessment of the Liver in SCD in a Tertiary Hospital in South-South, Nigeria

Risk Factors for Clinical Seizures in Neonates with Hypoxic–ischemic Encephalopathy Treated with Therapeutic Hypothermia

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