Influência do perfil hemolítico na evolução clínica dos pacientes com anemia falciforme

Abstract

Introduction: Sickle cell anemia presents obvious phenotypic variability. We can classify patients into ischemic or hemolytic profile. The differentiation of these can be done with observation of certain clinical manifestations and laboratory measurements that demonstrate whether or not a pattern of chronic hemolysis or exacerbated predominance of vaso-occlusive events, respectively. This diversity suggests that treatments could be addressed from such aspects, and that combinations of treatments are probably more than a single modality. Purpose: To define the main influences of the hemolytic profile in the clinical evolution of patients diagnosed with sickle cell anemia. Methods: Prospective cohort study, with some variables assessed across. Patients with sickle cell anemia, in a department of Northeast Brazil were included. The requested records and routine laboratory tests were reviewed. The variables that were classified hemolysis LDH, indirect bilirubin, hemoglobin, reticulocyte count, aspartate transaminase (AST) and need for transfusion. Results: 257 patients with sickle cell disease with a mean age of 12.4 years were studied. The study found no interrelation between the hemolytic pattern and clinical manifestations of sickle cell patients. The use of hydroxyurea and blood transfusion did not improve the rate of hemolysis of the patients studied. Evidenced improvement of hemolytic indices in patients who underwent prior splenectomy.