Coagulation profile of Sudanese children with homozygous sickle cell disease and the effect of treatment with omega-3 fatty acid on the coagulation parameters

Awoda, Shiek and Daak, Ahmed and Husain, Nazik Elmalaika and Ghebremeskel, Kebreab and Elbashir, M. I. (2017) Coagulation profile of Sudanese children with homozygous sickle cell disease and the effect of treatment with omega-3 fatty acid on the coagulation parameters. BMC Hematology, 17 (18). pp. 1-7.

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Abstract

Background:
It has been reported that patients with SCD do have an abnormal coagulation profile. Coagulopathy is thought to be one of the key factors that contribute to the vaso-occlusive crisis that characterises sickle cell disease (SCD). In this study, we investigated whether Sudanese sickle cell patients have an abnormal coagulation profile. In addition, the effect of treatment with either omega-3 fatty acids or hydroxyurea on coagulation profile was assessed.

Methods:
Homozygous SCD patients untreated (n = 52), omega-3 treated (n = 44), hydroxyurea (HU) treated (n = 8) and healthy (HbAA) controls (n = 52) matched for age (4–20 years), gender and socioeconomic status were enrolled. Patients on omega-3 fatty acids, according to age, received one to four capsules containing 277.8 mg DHA and 39.0 mg eicosapentnoic. Patients on Hydroxyurea were in on dosage more than 20 mg/kg/day. The steady state levels of the coagulation parameters and the effect of the treatments with either HU or omega-3 fatty acids on markers of coagulation were investigated.

Results:
Compared to the healthy controls, treated and untreated HbSS patients had lower hemoglobin, plasma Protein C, proteins S and higher white blood cell count (WBC), platelets count (PLTs) and plasma D-dimer levels,(p < 0.05). In comparison to untreated HbSS, treatment with neither omega-3 nor HU had effect on the WBC, plasma proteins C and S, (p > 0.05). HU treated group had a lower PLTs count compared to HbSS untreated group (p < 0.5). The prothrombin and activated partial thromboplastin times and international normalized ratio (INR) of untreated patients are significantly higher than n-3 treated, HU-treated patients and health controls, (p < 0.05). Patients treated with omega-3 had lowered D-dimer levels in comparison to HU-treated and untreated HbSS patients, (p < 0.001).

Conclusion:
This study provides evidence that Sudanese patients have abnormal coagulation profile and treatment with either HU or omega-3 fatty acids might partially ameliorate SCD-associated chronic coagulopathic state. Keywords: Sickle cell disease, Coagulation, Omega-3 fatty acids, D-dimer, Protein C, Protein S

Item Type: Article
Uncontrolled Keywords: Sickle cell disease, Coagulation, Omega-3 fatty acids, D-dimer, Protein C, Protein S
Subjects: 500 Natural Sciences and Mathemetics > 570 Life sciences; biology
Department: School of Human Sciences
Depositing User: Kebreab Ghebremeskel
Date Deposited: 13 Nov 2017 10:26
Last Modified: 13 Nov 2017 10:26
URI: http://repository.londonmet.ac.uk/id/eprint/1277

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