Assessment of serpin A5 levels and coagulation parameters of sickle cell anemia patients during bone pain vaso-occlusive crisis and steady state

Abstract

Background Sickle cell anemia (SCA) is an inherited disorder linked to numerous complications including vaso-occlusive bone pain crisis. It is also associated with hypercoagulability and thromboembolic complications as a result of an imbalance between antithrombotic and prothrombotic substances, some of which are serpin A5 and D-dimer. This study aimed to assess these parameters during vaso-occlusive bone pain crisis and in steady state. Patients and methods This was a cross-sectional and prospective study involving SCA participants attending the Lagos State University Teaching Hospital, Ikeja following approval of the site’s Health Research and Ethics Committee. Enzyme-linked immunosorbent assay was used to assay serpin A5 during vaso-occlusive bone pain crisis and in the same set of patients 3 months after, when they were in steady state. Similarly, D-dimers and prothrombin time were also performed in both crisis and steady states. Full blood count was done during vaso-occlusive crisis only. Data were analyzed with the Statistical Package for the Social Sciences (SPSS), version 23; P value was set at less than or equal to 0.05. Results A total of 44 participants were enrolled into the study with a mean age of 26.55 ± 7.31 years. The mean concentrations of serpin A5, D-dimer, and prothrombin time in crisis is and steady states were 0.57 ± 0.14 and 0.51 ± 0.11 mg/ml, 1613.12 ± 790.45 and 1209.95 ± 639.56 mg/ml, and 17.96 ± 1.55 and 17.04 ± 1.20 s, respectively. Paired t test in crisis and steady state for serpin A5 and prothrombin time were statistically significant. P values were 0.02 and 0.01, respectively, but not significant with D-dimer; the P value was 0.11. Conclusion The mean concentrations of serpin A5, D-dimer, and prothrombin time are higher in the SCA bone pain crisis compared with steady state.