PB1398 - Comparative analysis of thrombomodulin, lactate dehydrogenase and hemogram levels in predicting the clinical manifestation of leg ulcer in sickle cell disease

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Helen Chioma Okoye, MBBS, MSc, MD, FMCPath, FWACP

Associate Professor of Haematology/Consultant Haematologist
Department of Haematology and Immunology, College of Medicine, University of Nigeria
Enugu, Enugu, Nigeria

Co-Author(s)

SO

Sunday Ocheni

Professor of Haematology
College of Medicine, University of Nigeria
Enugu, Enugu, Nigeria
Theresa U. Nwagha, MD, MPH, FMCPath, MSc

Consultant Haematologist
University of Nigeria , College of Medicine Ituku Ozalla Campus
Enugu, Enugu, Nigeria
cE

chioma Sandra Ejezie, V

Consultant Haematologist
University of Nigeria Teaching Hospital Ituku-Ozalla Enugu Nigeria
Enugu, Enugu, Nigeria
cn

charles E. nonyelu

Consultant Haematologist
University of Nigeria Teaching Hospital Ituku-Ozalla Enugu
Enugu, Jigawa, Nigeria
ON

Oji Nnachi

Specialist Trainee
Alex Ekwueme Federal University Teaching Hospital, Abakaliki
Abakaliki, Ebonyi, Nigeria
oO

onochie I. Obodo

Trainee Haematologist
University of Nigeria Teaching Hospital, Enugu
Enugu, Enugu, Nigeria
OA

Omolade Awodu

Professor of Haematology
University of Benin
Benin City, Edo, Nigeria

Background: Sickle cell leg ulcer (SCLU) is a common complication of sickle cell disease (SCD) with complex pathogenesis involving endothelial dysfunction, hypercoagulability, hemolysis, and inflammation-mediated vasculopathy, Understanding the mechanisms behind these processes is crucial for developing effective strategies to manage and prevent SCLU.

Aims: To determine, if any, the association between specific blood biomarkers (serum thrombomodulin (TM ), lactate dehydrogenase (LDH), and hemogram) and the clinical manifestation of SCLU.

Methods: This was a cross-sectional study carried out among patients with SCLU with their age-matched SCD patients without leg ulcers. Venous blood samples were collected for the determination of TM (ELISA), FBC, and LDH levels. The study was approved by the institutional ethics committee. SPSS version 21 was employed in the statistical analysis. Statistical significance across means was determined using independent t-tests and the one-way Analysis of Variance (ANOVA)/F-test. Pearson’s correlation and linear regression analysis were used to determine the relationship between variables.

Results: Of the 82 consenting adults with SCD recruited, 41 had SCLU (test group) and 41 had no SCLU (control group). Their mean age was 33.34±9.01 and 32.98±8.45 (p = 0.30) respectively. Most ulcers were at stage 3. Hemogram, mean plasma levels of TM and LDH in study participants are presented on table 1. There was no significant statistical difference between plasma levels of TM and number (p value = 0.191) and severity/stage (p value =0.148) of the leg ulcers, see figure 1. In a bivariate analysis, TM was significantly associated with LDH only in the test-group. With multivariate analysis plasma TM levels failed to show any significant association with LDH.

Conclusion(s): SCLU is associated with higher levels of LDH, WBC and ALC and lower Hb concentration, which may be possible predictors of SCLU. The plasma TM levels showed no association with the occurrence and severity of SCLU.