LEUCOCYTE COUNT IN CHILDREN WITH SICKLE CELL ANAEMIA COMPARATIVE VALUES IN STEADY STATE, VASO-OCCLUSIVE CRISIS STATE AND BACTERIAL INFECTION

Chukwurah Ejike Felix, Obeagu Emmanuel Ifeanyi* and Emodi Nkoloka Obiageli

ABSTRACT

The effect of sickle cell disease (SCD) on total white blood cell (WBC) count, differential white blood cell count and packed cell volume (PCV) estimations were assayed on 64 known sickle cell disease patients attending sickle cell clinic at University of Nigeria Teaching Hospital (UNTH) Enugu. These three parameters were also assayed in 20 normal subjects that served as control. Sickle cell disease patients were grouped into four states namely steady state, vaso-occlusive crisis state, and steady state with bacterial infection and vaso-occlusive crisis state with bacterial infection. The mean PCV results of 22.70 ± 4.35%, 17.30 ± 2.99%, 19.27 ± 1.48% 20.40 ± 2.91% and 49.05 ±2.31 were recorded in SCD patients in steady state, vaso-occlusive crisis state, steady state with bacterial infection, vaso-occlusive crisis state with bacterial infection and control subjects respectively. The mean PCV of patients in the 4 different states of SCD significantly decreased (P<0.05) when compared with control subjects. The mean PCV of SCD patients in steady state increased significantly (p<0.05) when compared with those in vaso-occlusive crisis state. There was no significant difference between the mean PCV (P>0.05) of patients in steady state with bacterial infection and those in vaso -occlusive crisis state with bacterial infection. The mean total WBC count results of 15.14 ± 4.33 x 10 x 109/L, 26.34 ± 8.86 x 109/L, 17.87 ±_3.08 x 10 9/L, 19.50 ±_4.46 x 109/L, and 7.92 ± 2.53 x 10 9/L were recorded in SCD patients in steady state, vaso-occlusive crisis state, steady state with bacterial infection, vaso-occlusive crisis state with bacterial infection and control subject respectively. The mean total WBC count of patients in the 4 different states of SCD significantly increased (P<0.05) when compared with the control subjects. The mean total WBC count of SCD patients in steady state decreased significantly (P< 0.10) when compared with those in vaso-occlusive crisis state but that in steady state with bacterial infection decreased significantly (P>0.05) when compared with those in vaso-occlusive crisis state with bacterial infection. The mean neutrophil count results of 50.60 ± 13.68%, 61.30±19.29%, 59.67±2.27%, 70.10±8.88%. and 43.40± 2.67% were recorded in SCD patients in steady state, vaso-occlusive crisis state, steady state with bacterial infection, vaso-occlusive crisis state with bacterial infection and control subjects respectively. The mean neutrophil count of patients in the 4 different states of SCD significantly increased (P<0.05) when compared with the control subjects. The mean neutrophil count of SCD patients in steady state decreased significantly (P < 0.10) when compared with those in vaso-occlusive crisis state but that in steady state with bacterial infection decreased significantly (P<0.05) compared with that in vaso-occlusive crisis state with bacterial infection. The mean lymphocyte count results of 45.80± 15.55%, 34.20± 18.31%, 37.80± 2.51%, 24.11± 8.71% and 54.20± 2.96% were recorded in SCD patients in steady state, vaso-occlusive crisis state, steady state with bacterial infection, vaso-occlusive crisis state with bacterial infection and control subjects respectively. The mean lymphocyte count of patients in the 4 different states of SCD significantly decreased (P<0.05) when compared to control subjects. The mean lymphocyte count of SCD patients in steady state increased significantly (P<0.10) when compared with those in vaso-occlusive crisis state but that in steady state with bacterial infection increased significantly (P<0.05) compared with that in vaso-occlusive crisis state with bacterial infection. There was no much difference in the eosinphil and monocyte count in the 4 different states of SCD patients when compared with each other and with the control subjects. Out of the 64 bacterial cultures done, 37.5% yielded significant growth and the organisms isolated include Staphylococcus aureus. Klebsiella aerogenes. Escherichia coli, Pseudomonas aeruginosa and Streptococcus pyogenes with Staphylococcus aureus being the most predominant.

Keywords: leucocyte count, children, sickle cell anaemia, steady state, vaso-occlusive crisis state, bacterial infection.