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Morbidity pattern and interferon gamma level in sickle cell anemia patients with autosplenectomy.
Niger J Clin Pract 2018; 21(12):1615-1621NJ

Abstract

Introduction

In sickle cell anemia patients (SCA), the spleen suffers multiple occlusion of its microvasculature causing ischemia and subsequently autosplenectomy. Among the functions of the spleen is the production of gamma interferon (IFN-γ) which has several immunological roles. This function could be impaired in these patients. Therefore, this study aimed at determining the extent to which autosplenectomy affects the immunity of SCA patients as reflected by the level of IFN-γ, frequency of infections, and crises (vaso-occlusive, hemolytic, aplastic) in these patients.

Materials and Methods

Forty SCA patients in steady state condition were recruited into the study. A self-administered questionnaire was completed by all patients, and venous blood sample was analyzed for IFN-γ levels. All patients underwent abdominal ultrasound scan.

Results

Autosplenectomy was observed in 20% of the sickle cell patients. Bone pain was the most frequent type of crisis in the study population; this occurred in 100% and 85% of patients with autosplenectomy and those without autosplenectomy, respectively. Infection rates of more than once a year was reported in 87.5% of SCA patients with autosplenectomy compared with 50% of SCA patients without autosplenectomy. There was no significant difference in IFN-γ plasma levels between SCA patients with autosplenectomy and those without autosplenectomy.

Conclusion

This study showed a higher prevalence of infection and bone pain crisis among SCA patients with autosplenectomy than in SCA patients without autosplenectomy. It also showed comparable level of IFN-γ in the 2 groups of patients. Patients with autosplenectomy may benefit from early institution of drugs such as hydroxyurea to improve quality of life.

Authors+Show Affiliations

Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.Department of Haematology, Faculty of Basic Medical Science, College of Medicine, University of Ibadan, Ibadan, Nigeria.Department of Radiology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.Department of Immunology, Faculty of Basic Medical Science, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30560826

Citation

Okongwu, C I., et al. "Morbidity Pattern and Interferon Gamma Level in Sickle Cell Anemia Patients With Autosplenectomy." Nigerian Journal of Clinical Practice, vol. 21, no. 12, 2018, pp. 1615-1621.
Okongwu CI, Fasola FA, Adekanmi AJ, et al. Morbidity pattern and interferon gamma level in sickle cell anemia patients with autosplenectomy. Niger J Clin Pract. 2018;21(12):1615-1621.
Okongwu, C. I., Fasola, F. A., Adekanmi, A. J., & Onifade, A. A. (2018). Morbidity pattern and interferon gamma level in sickle cell anemia patients with autosplenectomy. Nigerian Journal of Clinical Practice, 21(12), pp. 1615-1621. doi:10.4103/njcp.njcp_217_18.
Okongwu CI, et al. Morbidity Pattern and Interferon Gamma Level in Sickle Cell Anemia Patients With Autosplenectomy. Niger J Clin Pract. 2018;21(12):1615-1621. PubMed PMID: 30560826.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Morbidity pattern and interferon gamma level in sickle cell anemia patients with autosplenectomy. AU - Okongwu,C I, AU - Fasola,F A, AU - Adekanmi,A J, AU - Onifade,A A, PY - 2018/12/19/entrez PY - 2018/12/19/pubmed PY - 2019/1/19/medline KW - Autosplenectomy KW - gamma interferon KW - infection KW - sickle cell anemia SP - 1615 EP - 1621 JF - Nigerian journal of clinical practice JO - Niger J Clin Pract VL - 21 IS - 12 N2 - Introduction: In sickle cell anemia patients (SCA), the spleen suffers multiple occlusion of its microvasculature causing ischemia and subsequently autosplenectomy. Among the functions of the spleen is the production of gamma interferon (IFN-γ) which has several immunological roles. This function could be impaired in these patients. Therefore, this study aimed at determining the extent to which autosplenectomy affects the immunity of SCA patients as reflected by the level of IFN-γ, frequency of infections, and crises (vaso-occlusive, hemolytic, aplastic) in these patients. Materials and Methods: Forty SCA patients in steady state condition were recruited into the study. A self-administered questionnaire was completed by all patients, and venous blood sample was analyzed for IFN-γ levels. All patients underwent abdominal ultrasound scan. Results: Autosplenectomy was observed in 20% of the sickle cell patients. Bone pain was the most frequent type of crisis in the study population; this occurred in 100% and 85% of patients with autosplenectomy and those without autosplenectomy, respectively. Infection rates of more than once a year was reported in 87.5% of SCA patients with autosplenectomy compared with 50% of SCA patients without autosplenectomy. There was no significant difference in IFN-γ plasma levels between SCA patients with autosplenectomy and those without autosplenectomy. Conclusion: This study showed a higher prevalence of infection and bone pain crisis among SCA patients with autosplenectomy than in SCA patients without autosplenectomy. It also showed comparable level of IFN-γ in the 2 groups of patients. Patients with autosplenectomy may benefit from early institution of drugs such as hydroxyurea to improve quality of life. SN - 1119-3077 UR - https://www.unboundmedicine.com/medline/citation/30560826/Morbidity_pattern_and_interferon_gamma_level_in_sickle_cell_anemia_patients_with_autosplenectomy L2 - http://www.njcponline.com/article.asp?issn=1119-3077;year=2018;volume=21;issue=12;spage=1615;epage=1621;aulast=Okongwu DB - PRIME DP - Unbound Medicine ER -