Quantification of Sickle Cells in the Peripheral Smear as a Marker of Disease Severity

Abstract

Blinded readers examined peripheral smears of 108 children with steady sickle cell (SC) disease and controls by counting ten 100× microscope fields and calculating percent of irreversible and reversible SC from total red cell population SC index (SCI). SCI was correlated to disease severity, and transfusion, hydroxyurea, or neither. Controls had a mean of 0.28% SC (range 0-0.64). Children with hemoglobin SS had a mean SCI of 5.12% ± 5.37 (range 0-30). SCI increased 0.33% with each increasing year (p <0.0001). Patients with SCI > 0.64 were 3.32 times as likely to experience clinical complications (p = 0.0124). Although blood transfusions and hydroxyurea decreased percent of SC, 72% treated patients had SCI >0.64, correlating with persistent sickling. This standardized method quantifies SC in peripheral smears. Percent of SC increased with age and correlated with disease severity, especially hemolytic complications, providing readily available information with minimal or no extra cost.

Assessment of iron status and interplay between lipid peroxidation and antioxidant capacity in common hemoglobin variants in Osun State, southwestern Nigeria

“…Meanwhile, accumulation of MDA in the blood system is another key factor that may disrupt organization of the phospholipid bilayer within the erythrocyte membrane. 25 The increased MDA level in this study was evidence of increased lipid peroxidation and might be exacerbated upon depletion of some ironcontaining antioxidant enzymes, as earlier mentioned. 2 More so, subjects with sickle cell (SCT) and Hb C traits are identified as carriers, and they are usually considered to be benign and asymptomatic conditions owing to the level of MDA in their blood system.…”

“…However, there was a remarkable increase in the HbSS group (Figure ). Meanwhile, accumulation of MDA in the blood system is another key factor that may disrupt organization of the phospholipid bilayer within the erythrocyte membrane . The increased MDA level in this study was evidence of increased lipid peroxidation and might be exacerbated upon depletion of some iron‐containing antioxidant enzymes, as earlier mentioned .…”

Validity of simple clinical and biological parameters as screening tool for sickle cell anemia for referral to tertiary center in highly resource constraints

“…In our series, sickle cells (PPV: 100%, NPV: 98%, sensitivity: 50%, specificity: 100%, κ value: .66) were also found to be the most predictive factor for diagnosis of SCD. This finding reported in our cohort was similar to those reported by previous studies …”

“…This finding reported in our cohort was similar to those reported by previous studies. [20][21][22] In the DRC, malaria is holoendemic and characterized by a high and stable transmission. Plasmodium falciparum is the most prevalent species and contributes around 97% of episodes of malaria.…”

Osmolality Threshold for Sickle Cell Erythrocyte Hemolysis

“…The proportion and variants of hemoglobin in sickle cell disease may explain the difference in osmolality threshold for hemolysis between the normal and sickle cell blood. Evidence suggests that sickling in sickle cells blood constitute about 5-50% of the total number of red cells in the peripheral smear [14]. The higher the proportion of sickle and fetal hemoglobin compared to the major Hemoglobin (HbAA), which generally constitutes approximately 97% of the total hemoglobin in normal red cells, the more prominent the right shift or differences between the two specimens [15].…”