Microparticle profile during painful crisis and steady state in sickle cell anemia

Introduction: Sickle cell anemia is a disease which is characterized with hemolytic anemia, hypercoagulopathy and painful crisis. Microparticles are 0,1-1 µm sized little membrane particles which are derived during activation or apoptotic phase of cell cycle. It is reported that microparticles are increased in many systemic disease including sickle cell anemia. Aim: In this study we aimed to investigate the role of microparticles on clinical state and prognosis during crisis and steady state in sickle cell anemia patients. Materials and method: Twenty nine patients, following by Çukurova University Department of Pediatric Hematology, were included in this study. Blood samples were collected in 26 of these patients in steady state. Control group was formed with 18 healthy children without any systemic disease. Complete blood count, hemoglobin electrophoresis and biochemical parameters are studied in both groups. Also patients? total microparticle levels, erythrocyte (CD235a), endothelia (CD106), monocyte (CD14) microparticle levels and tissue factor expressing (CD142) microparticle levels were studied by flow cytometry and whole data was statistically analyzed. Findings: Hemoglobin and hematocrit levels were significantly low in sickle cell anemia patients (p<0,001). Levels of HbS were significantly high during crisis period comparing with mean HbS levels during steady state (p<0,001). Total microparticle levels were significantly high in sickle cell anemia patients with painful crisis comparing with control group (p<0,05). Erythrocyte and monocyte microparticle levels were significantly high in patients with painful crisis comparing with steady state (p<0,05). Endothelial and tissue factor expressing microparticle levels were high in patiens with crisis comparing to steady state but this was not statistically significant (p>0,05). There was not any significant relation with microparticle levels and femur or humerus head avascular necrosis (p>0,05). There was not any significant relation with frequency of crisis and microparticle levels (p>0,05). Microparticle levels were low in patients whose were taking hydroxiurea treatment comparing with non-hydroxiurea treatment but this data was not statistically significant (p>0,05). Result: As a result we found high levels of total microparticle, erythrocyte and monocyte microparticles in sickle cell anemia patients during painful crisis period. We need many and bigger studies in order to understand the effect of microparticles on prognosis of sickle cell anemia. Keywords: children, microparticle, sickle cell anemia