Int J Clin Exp Med 2015;8(7):11442-11448 www.ijcem.com /ISSN:1940-5901/IJCEM0007429
Original Article Mortal quintet of sickle cell diseases Mehmet Rami Helvaci1, Cumali Gokce1, Ramazan Davran2, Seckin Akkucuk3, Mustafa Ugur3, Cem Oruc3 Departments of 1Internal Medicine, 2Radiology, 3General Surgery, Medical Faculty of The Mustafa Kemal University, Turkey Received February 28, 2015; Accepted July 10, 2015; Epub July 15, 2015; Published July 30, 2015 Abstract: Background: Sickle cell diseases (SCDs) are chronic inflammatory processes on capillary level. We tried to understand some possible correlations between stroke and severity of SCDs. Methods: All patients with SCDs were taken into the study. Results: The study included 343 patients (174 males and 169 females). There were 30 cases (8.7%) with stroke. The mean ages were similar in both groups (32.5 versus 29.1 years in the stroke group and other, respectively, P>0.05). The female ratios were similar in both groups, too (43.3% versus 49.8%, respectively, P>0.05). Prevalences of associated thalassemia minors were also similar in them (73.3% versus 65.1%, respectively, P>0.05). Smoking was higher among the stroke cases, significantly (26.6% versus 13.0%, P0.05 for all). On the other hand, although the painful crises per year, tonsilectomy, priapism, ileus, pulmonary hypertension, chronic obstructive pulmonary disease, coronary heart disease, chronic renal disease, rheumatic heart disease, avascular necrosis of bones, cirrhosis, and mortality were all higher in the stroke group, the differences were only significant for acute chest syndrome (ACS), digital clubbing, and leg ulcers (P0.05). The female ratios were similar in both groups, too (43.3% versus 49.8%, respectively,
Int J Clin Exp Med 2015;8(7):11442-11448
Mortal quintet of sickle cell diseases Table 2. Peripheric blood values of the study cases Variables Mean WBC* counts (µL) Mean Hct‡ value (%) Mean PLT§ counts (µL)
Cases with stroke
p-value
Cases without stroke
14.292 ± 4.861 (7.310-26.020)
Ns†
15.151 ± 6.581 (1.580-39.200)
23.2 ± 5.0 (12-36)
Ns
23.7 ± 4.9 (11-42)
383.070 ± 176.318 (114.000-955.000)
Ns
460.030 ± 232.897 (48.000-1.827.000)
*White blood cell, †Nonsignificant (P>0.05), ‡Hematocrit, §Platelet.
Discussion
Table 3. Associated pathologies of the study cases Variables Painful crises per year Tonsilectomy Priapism Ileus Leg ulcers Digital clubbing
Cases with stroke p-value Cases without stroke 7.4 ± 11.4 (0-36) Ns* 4.8 ± 7.6 (0-52) 6.6% (2) Ns 4.7% (15) 3.3% (1) Ns 2.5% (8) 6.6% (2) Ns 1.9% (6) 26.6% (8) 0.05). increase BP further. But as also understood Interestingly, smoking was higher among the from the digital clubbing cases [12], the atherostroke cases, significantly (26.6% versus sclerotic process may initially affect the affer13.0%, P0.05 for all) (Table 2). On the other hand, changes. But after development of COPD, ciralthough the painful crises per year, tonsilectorhosis, CRD, CHD, PAD, or stroke, the vascular my, priapism, ileus, pulmonary hypertension, changes could not be reversed probably due to COPD, CHD, CRD, rheumatic heart disease, the irreversible fibrotic results on the endotheavascular necrosis of bones, cirrhosis, and lium. The same fact may also be true for the mortality were all higher in the stroke group, other causes of atherosclerosis including the differences were only significant for digital excess weight, increased serum glucose and clubbing, leg ulcers, and ACS (P
Original Article Mortal quintet of sickle cell diseases Mehmet Rami Helvaci1, Cumali Gokce1, Ramazan Davran2, Seckin Akkucuk3, Mustafa Ugur3, Cem Oruc3 Departments of 1Internal Medicine, 2Radiology, 3General Surgery, Medical Faculty of The Mustafa Kemal University, Turkey Received February 28, 2015; Accepted July 10, 2015; Epub July 15, 2015; Published July 30, 2015 Abstract: Background: Sickle cell diseases (SCDs) are chronic inflammatory processes on capillary level. We tried to understand some possible correlations between stroke and severity of SCDs. Methods: All patients with SCDs were taken into the study. Results: The study included 343 patients (174 males and 169 females). There were 30 cases (8.7%) with stroke. The mean ages were similar in both groups (32.5 versus 29.1 years in the stroke group and other, respectively, P>0.05). The female ratios were similar in both groups, too (43.3% versus 49.8%, respectively, P>0.05). Prevalences of associated thalassemia minors were also similar in them (73.3% versus 65.1%, respectively, P>0.05). Smoking was higher among the stroke cases, significantly (26.6% versus 13.0%, P0.05 for all). On the other hand, although the painful crises per year, tonsilectomy, priapism, ileus, pulmonary hypertension, chronic obstructive pulmonary disease, coronary heart disease, chronic renal disease, rheumatic heart disease, avascular necrosis of bones, cirrhosis, and mortality were all higher in the stroke group, the differences were only significant for acute chest syndrome (ACS), digital clubbing, and leg ulcers (P0.05). The female ratios were similar in both groups, too (43.3% versus 49.8%, respectively,
Int J Clin Exp Med 2015;8(7):11442-11448
Mortal quintet of sickle cell diseases Table 2. Peripheric blood values of the study cases Variables Mean WBC* counts (µL) Mean Hct‡ value (%) Mean PLT§ counts (µL)
Cases with stroke
p-value
Cases without stroke
14.292 ± 4.861 (7.310-26.020)
Ns†
15.151 ± 6.581 (1.580-39.200)
23.2 ± 5.0 (12-36)
Ns
23.7 ± 4.9 (11-42)
383.070 ± 176.318 (114.000-955.000)
Ns
460.030 ± 232.897 (48.000-1.827.000)
*White blood cell, †Nonsignificant (P>0.05), ‡Hematocrit, §Platelet.
Discussion
Table 3. Associated pathologies of the study cases Variables Painful crises per year Tonsilectomy Priapism Ileus Leg ulcers Digital clubbing
Cases with stroke p-value Cases without stroke 7.4 ± 11.4 (0-36) Ns* 4.8 ± 7.6 (0-52) 6.6% (2) Ns 4.7% (15) 3.3% (1) Ns 2.5% (8) 6.6% (2) Ns 1.9% (6) 26.6% (8) 0.05). increase BP further. But as also understood Interestingly, smoking was higher among the from the digital clubbing cases [12], the atherostroke cases, significantly (26.6% versus sclerotic process may initially affect the affer13.0%, P0.05 for all) (Table 2). On the other hand, changes. But after development of COPD, ciralthough the painful crises per year, tonsilectorhosis, CRD, CHD, PAD, or stroke, the vascular my, priapism, ileus, pulmonary hypertension, changes could not be reversed probably due to COPD, CHD, CRD, rheumatic heart disease, the irreversible fibrotic results on the endotheavascular necrosis of bones, cirrhosis, and lium. The same fact may also be true for the mortality were all higher in the stroke group, other causes of atherosclerosis including the differences were only significant for digital excess weight, increased serum glucose and clubbing, leg ulcers, and ACS (P
