Correlation of low levels of nitrite and high levels of fetal hemoglobin in patients with sickle cell disease at baseline

• Main Authors: Darcielle Bruna Dias Elias, Lilianne Brito da Silva Rocha, Maritza Barbosa Cavalcante, Alano Martins Pedrosa, Izabel Cristina Bandeira Justino, Romélia Pinheiro Gonçalves
• Format: Article
• Language: English
• Published: Elsevier 2012-01-01
• Series: Revista Brasileira de Hematologia e Hemoterapia
• Subjects: Lactate dehydrogenase; Malonaldehyde; Anemia, sickle cell; Nitrite
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842012000400009
• ISSN: 1516-8484; 1806-0870

BACKGROUND: Sickle cell disease is a hemoglobinopathy characterized by hemolytic anemia, increased susceptibility to infections and recurrent vaso-occlusive crises that reduces the quality of life of sufferers. OBJECTIVE: To evaluate the correlation of the levels of lactate dehydrogenase, malonaldehyde and nitrite to fetal hemoglobin in patients with sickle cell disease not under treatment with hydroxyurea in outpatients at a university hospital in Fortaleza, Ceará, Brazil. METHODS: Forty-four patients diagnosed with sickle cell disease were enrolled at baseline. Diagnosis was confirmed by evaluating the beta globin gene using polymerase chain reaction-restriction fragment length polymorphism. The concentration of fetal hemoglobin was obtained by high-performance liquid chromatography. Serum levels of nitrite, malonaldehyde and lactate dehydrogenase were measured by biochemical methods. RESULTS: Significantly higher levels of lactate dehydrogenase, nitrite and malonaldehyde were observed in patients with sickle cell disease compared to a control group. The study of the correlation between fetal hemoglobin levels and these variables showed a negative correlation with nitrite levels. No correlation was found between fetal hemoglobin and malonaldehyde or lactate dehydrogenase. When the study population was stratified according to fetal hemoglobin levels, a decrease in the levels of nitrite was observed with higher levels of fetal hemoglobin (p-value = 0.0415). CONCLUSION: The results show that, similar to fetal hemoglobin levels, the concentration of nitrite can predict the clinical course of the disease, but should not be used alone as a modulator of prognosis in patients with sickle cell disease.