Evaluation of total antioxidant status among pediatric sickle cell anemia patients and hemoglobin AA controls

Background: Sickle cell anemia (SCA) is a major health problem in many parts of the world particularly in Sub-Saharan African countries. The disorder is characterized by chronic hemolytic events that result in increased generation of free radicals leading to excessive consumption and depletion of body antioxidants. Aim: This study evaluated the total antioxidant status (TAS) of children with SCA, aged 1–17 years, comparing findings among steady state, vaso-occlusive crisis and hemoglobin AA (HbAA) matched controls. Materials and Methods: Study participants were 50 children with SCA and 50 HbAA matched controls. Sociodemographic characteristics and clinical history were documented using pre-tested interviewer-administered questionnaires. Physical examination was conducted and blood samples collected for serum TAS estimation. Data analysis was carried out using SPSS version 21 and P-value of significance was set at <0.05. Results: SCA subjects in vaso-occlusive crisis had lower mean serum TAS level than those in steady state (7.4 ± 3.5 vs 8.4 ± 4.0mmol/L) but this difference was not statistically significant (P = 0.18). The mean TAS level of SCA patients either in steady state (8.4 ± 4.0 mmol/L) or vaso-occlusive crisis (7.5 ± 3.5 mmol/L) was higher than 7.0 ± 4.1 mmol/L for matched (HbAA) controls but the difference was also not statistically significant (F = 1.54, P = 0.09). Conclusion: This study shows that the TAS level of SCA children in steady state was higher than that of those in vaso-occlusive crisis, though not statistically significant. This may be an adaptive mechanism to counteract the oxidative stress seen in chronic inflammatory conditions like SCA.