Evaluation of clinical findings by thrombocyte activation, inhibition or adhesivity in sickle cell crises

Aim: In this study, it was aimed to evaluate the relationship between platelet activation, inhibition or adhesiveness in sickle cell crisis and the clinic of the disease. Materials and method: In this study, blood samples were taken from 30 patients with sickle cell anemia, who were followed up in Çukurova University Faculty of Medicine, Department of Pediatric Hematology, during the crisis period. As a control group, blood samples were taken from 30 healthy children without a chronic disease. Complete blood count and biochemistry parameters were studied in the patient and control groups. In addition, in order to prevent extracellular activation of platelets in the sample, blood sample was mixed with fixative solution to be equal to the amount of blood in it as soon as it was taken. The solution prepared for flow cytometric analysis was incubated with CD14, CD16 and CD42a monoclonal antibodies. Flow cytometry device was used to determine the granulocyte-platelet and monocyte-platelet aggregates in the whole blood sample. In flow cytometry analysis, monocytes were detected with strong CD14 expression and granulocyte cells were detected with CD16 expression. In order to detect monocyte-platelet and granulocyte-platelet aggregates, the percentages of CD14+/CD42a+, CD16+/CD42a+ cell groups were calculated, respectively. Findings: Hemoglobin, hematocrit, and mean platelet volume (MPV) values were lower in patients with sickle cell crisis compared to the control group (p<0.05). Platelet, leukocyte and neutrophil counts were found to be significantly higher in the patient group than in the control group (p <0.05). The mean CD14/CD42a value of the patient group was 26±22.6%; mean was 10.1±3.4 in the control group. The difference was found to be statistically significant (p=0.001). The mean CD16/CD42a value obtained from the patient group was 19.8±17.9% and the mean CD16/CD42a value obtained from the control group was 9.8±3.5%, and there was a significant difference between the two groups (p=0.001). When the patients were divided into two groups according to their pain scores and their CD14/CD42a and CD16/CD42a values were compared, it was found that there were no statistically significant differences between the two groups (p=0.172 and p=0.983, respectively). Result: As a result of the study, CD14/CD42a and CD16/CD42a values were found to be high in patients with sickle cell crisis. However, more comprehensive studies are needed to clearly reveal the relationship between sickle cell crisis and platelet adhesion.