A study on C-reactive protein as an early marker of vasococclusive crisis in sickle disorders

Abstract

Background: Sickle cell disease (SCD) patients often seek care in the Emergency Department (ED) due to vaso-occlusive crisis (VOC), the most common complication of SCD. Currently, no diagnostic test can determine if a SCD patient is having an acute VOC. Methodology: Irrespective of the clinical diagnosis and type of sickle cell crises the confirmation of haemoglobin pattern in sickle cell disease patients and healthy subjects were done by sickling test, hemoglobin electrophoresis or high performance liquid chromatography. Results: Irrespective of age and sex, most common variety of vaso-occlusive crisis was bony crisis including hand foot syndrome. About 91.2% patients demonstrated CRP positivity during the early phase of vaso-occlusive crisis. Subsequently the CRP positivity rate declined in the mid phase (28%) and late phase (2.4%) of vaso-occlusive crisis reflecting response to therapy. There is a significant difference of CRP status between non vasoocclusive and vaso–occlusive crisis of sickle cell disease patients. About 96.3% patients of non vaso-occlusive crisis became CRP negative during their whole course of their crisis. Conclusion: Analysis of large number of cases with sickle cell vaso-occlusive crisis with quantitative serial measurement of CRP level is needed for better evaluation of patients during prodromal phase for effective and better management of these patients.