Enhanced Hypercoagulability in Sickle Cell Anaemia Patients with Chronic Leg Ulcers
Sickle Cell Anaemia (SCA) is associated with a hypercoagulable state resulting in a predisposition to venous thromboembolism. With improvements in the quality of care, more patients with SCA survive into adulthood with an associated increase in the frequency of end-organ damage and chronic complicat...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Advances in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2020/5157031 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832554482745999360 |
|---|---|
| author | David Sackey Yvonne Dei-Adomakoh Edeghonghon Olayemi |
| author_facet | David Sackey Yvonne Dei-Adomakoh Edeghonghon Olayemi |
| author_sort | David Sackey |
| collection | DOAJ |
| description | Sickle Cell Anaemia (SCA) is associated with a hypercoagulable state resulting in a predisposition to venous thromboembolism. With improvements in the quality of care, more patients with SCA survive into adulthood with an associated increase in the frequency of end-organ damage and chronic complications such as chronic leg ulcers (CLUs). These ulcers rarely occur in the first decade of life and are recurrent, painful, and slow-to-heal. This study tested the hypothesis that coagulation is enhanced in SCA patients with CLU. 145 participants (50 SCA with CLU, 50 SCA without CLU, and 45 with haemoglobin AA) were assessed to determine their coagulation profile using selected tests of coagulation. The SCA with the CLU group had the lowest mean haemoglobin (Hb) concentration. SCA patients with and without CLUs had elevated mean platelet counts, shorter mean aPTT, and marginally prolonged mean PT compared to HbAA patients. SCA with CLUs patients had a significantly shortened aPTT than those without CLUs (p = 0.035) and HbAA (p = 0.009). There were significant differences in the mean PT between SCA with CLUs patients and HbAA (p = 0.017); SCA without CLU and HbAA (p = 0.014). SCA with and without CLUs patients had higher mean D-dimer levels compared to HbAA. There was a negative correlation between Hb concentration and duration of CLU (r = -0.331, p = 0.021). In conclusion, our study demonstrates a heightened hypercoagulability in SCA patients with CLUs. We did not test for platelet activation, and it is not clear what role, if any, the enhanced hypercoagulability plays in the pathogenesis of CLUs in SCA. It will be useful to ascertain if antiplatelet agents or/and anticoagulants quicken the healing of CLUs in SCA patients. |
| format | Article |
| id | doaj-art-1c162391306b4c1a9c93264da6f4ad36 |
| institution | Kabale University |
| issn | 1687-9104 1687-9112 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Hematology |
| spelling | doaj-art-1c162391306b4c1a9c93264da6f4ad362025-02-03T05:51:16ZengWileyAdvances in Hematology1687-91041687-91122020-01-01202010.1155/2020/51570315157031Enhanced Hypercoagulability in Sickle Cell Anaemia Patients with Chronic Leg UlcersDavid Sackey0Yvonne Dei-Adomakoh1Edeghonghon Olayemi2Haematology Unit, Komfo Anokye Teaching Hospital, Kumasi, GhanaDepartment of Haematology, University of Ghana Medical School, Accra, GhanaDepartment of Haematology, University of Ghana Medical School, Accra, GhanaSickle Cell Anaemia (SCA) is associated with a hypercoagulable state resulting in a predisposition to venous thromboembolism. With improvements in the quality of care, more patients with SCA survive into adulthood with an associated increase in the frequency of end-organ damage and chronic complications such as chronic leg ulcers (CLUs). These ulcers rarely occur in the first decade of life and are recurrent, painful, and slow-to-heal. This study tested the hypothesis that coagulation is enhanced in SCA patients with CLU. 145 participants (50 SCA with CLU, 50 SCA without CLU, and 45 with haemoglobin AA) were assessed to determine their coagulation profile using selected tests of coagulation. The SCA with the CLU group had the lowest mean haemoglobin (Hb) concentration. SCA patients with and without CLUs had elevated mean platelet counts, shorter mean aPTT, and marginally prolonged mean PT compared to HbAA patients. SCA with CLUs patients had a significantly shortened aPTT than those without CLUs (p = 0.035) and HbAA (p = 0.009). There were significant differences in the mean PT between SCA with CLUs patients and HbAA (p = 0.017); SCA without CLU and HbAA (p = 0.014). SCA with and without CLUs patients had higher mean D-dimer levels compared to HbAA. There was a negative correlation between Hb concentration and duration of CLU (r = -0.331, p = 0.021). In conclusion, our study demonstrates a heightened hypercoagulability in SCA patients with CLUs. We did not test for platelet activation, and it is not clear what role, if any, the enhanced hypercoagulability plays in the pathogenesis of CLUs in SCA. It will be useful to ascertain if antiplatelet agents or/and anticoagulants quicken the healing of CLUs in SCA patients.http://dx.doi.org/10.1155/2020/5157031 |
| spellingShingle | David Sackey Yvonne Dei-Adomakoh Edeghonghon Olayemi Enhanced Hypercoagulability in Sickle Cell Anaemia Patients with Chronic Leg Ulcers Advances in Hematology |
| title | Enhanced Hypercoagulability in Sickle Cell Anaemia Patients with Chronic Leg Ulcers |
| title_full | Enhanced Hypercoagulability in Sickle Cell Anaemia Patients with Chronic Leg Ulcers |
| title_fullStr | Enhanced Hypercoagulability in Sickle Cell Anaemia Patients with Chronic Leg Ulcers |
| title_full_unstemmed | Enhanced Hypercoagulability in Sickle Cell Anaemia Patients with Chronic Leg Ulcers |
| title_short | Enhanced Hypercoagulability in Sickle Cell Anaemia Patients with Chronic Leg Ulcers |
| title_sort | enhanced hypercoagulability in sickle cell anaemia patients with chronic leg ulcers |
| url | http://dx.doi.org/10.1155/2020/5157031 |
| work_keys_str_mv | AT davidsackey enhancedhypercoagulabilityinsicklecellanaemiapatientswithchroniclegulcers AT yvonnedeiadomakoh enhancedhypercoagulabilityinsicklecellanaemiapatientswithchroniclegulcers AT edeghonghonolayemi enhancedhypercoagulabilityinsicklecellanaemiapatientswithchroniclegulcers |