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Serum homocysteine and disease severity in sickle cell anemia patients in Lagos

Authors Uche E, Adelekan O, Akinbami A, Osunkalu V, Ismail K, Ogbenna AA, Badiru M, Dosunmu A, Oluwole E, Kamson O

Received 15 December 2018

Accepted for publication 1 April 2019

Published 8 May 2019 Volume 2019:10 Pages 127—134


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Martin Bluth

Ebele Uche,1 Oluwaseun Adelekan,2 Akinsegun Akinbami,1 Vincent Osunkalu,3 Kamal Ismail,1 Ann Abiola Ogbenna,3 Mulikat Badiru,1 Adedoyin Dosunmu,1 Esther Oluwole,4 Omolara Kamson5

1Department of Haematology and Blood Transfusion, Lagos State University College of Medicine, Lagos, Nigeria; 2Department of Haematology and Blood Transfusion, General Hospital Marina, Lagos, Nigeria; 3Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, Nigeria; 4Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria; 5Department of Haematology and Blood Transfusion, Lagos State University Teaching Hospital, Lagos, Nigeria

Purpose: Hypercoagulability in sickle cell anemia (SCA) may be responsible for the increased development of vascular occlusion in certain organs as well as acute pain episodes. The causes of hypercoagulability in SCA are multifactorial and include raised homocysteine levels. This study, therefore, aimed to determine serum homocysteine levels in SCA patients in steady state and to correlate its levels with SCA disease severity.
Patients and Methods: This was a cross-sectional study done among SCA patients in steady state attending the Haematology Clinic of the Lagos State University Teaching Hospital (LASUTH). Matched age and sex HbAA controls were also recruited. Serum homocysteine of each participant was done with enzyme-linked immunosorbent assay and disease severity score assessed in every SCA patient using clinical and laboratory parameters.
Results: The mean value for homocysteine in the study group (SCA patients) was 19.80±19.75 μmol/L whilst that of the control group was 9.16±4.29 μmol/L. Thirty-nine out of 96 (46.6%) SCA patients had elevated homocysteine levels (>15 μmol/L) whilst all 96 participants in the control group had normal homocysteine levels. The difference in the means in the two groups was statistically significant with p=0.001. Majority (62.5%) of the SCA patients had a mild disease (severity score ≤3). There was a significant correlation between serum homocysteine levels and disease severity scores with p=0.04; χ2,=4.04.
Conclusion: Homocysteine levels were significantly higher in HbSS patients compared with matched HbAA controls and showed a positive correlation with disease severity scores in the SCA patients.

Keywords: sickle cell anemia, disease severity, homocysteine

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