Full Length Research Paper

Electrolyte profile and prevalent causes of sickle cell crisis in Enugu, Nigeria

E. O. Ibe¹*, A. C. J. Ezeoke², I. Emeodi³, E. I. Akubugwo⁴, E. Elekwa⁴, M. C. Ugonabo⁵ and W. C. Ugbajah⁶

¹Department of Chem. Path, University of Nigeria Teaching Hospital, Enugu, Nigeria.

²Department of Chem. Path, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

³Department of Paediatrics, University of Nigeria, Enugu Campus, Enugu, Nigeria.

⁴Department of Biochemistry, Abia State University, Uturu, Nigeria.

⁵Department of Chemical Pathology, College of Medicine, UNEC, Enugu, Nigeria.

⁶Temple University Hospital, Philadelphia, PA, 19140, USA.

*Corresponding author. E-mail: mascot7@yahoo.com .

Accepted 9 September, 2009

   Abstract

One hundred sickle cell patients aged between 6 - 25 years in steady state who attended Sickle Cell Clinic at University of Nigeria Teaching Hospital, Enugu, Nigeria were selected for this study. Out of this number, only thirty who were eventually admitted in crisis state within one year of this study were selected for subsequent investigations. They included 20 females and 10 males. We also selected thirty apparently healthy hemoglobin AA subjects, (17 males and 13 females) aged between 6 and 32 years to serve as secondary control. Samples were collected on the patient’s initial visit to the hospital (stable state). Samples were also collected on admission and 24 h after infusion therapy. Serum electrolytes, malarial parasite count, widal agglutination, blood and urine cultures were done using standard methods. The results showed a statistically significant decrease (p < 0.05) in mean sodium and potassium levels in crisis when compared with those in steady state. The electrolytes were assayed 24 h after rehydration of the patients in crisis. There were significant increases (p < 0.05), in mean sodium and potassium levels. Considering the prevalent causes of crisis, 63% of the subjects in crisis had malarial parasitaemia. 16.7% had bacterial infection and 13.3% were infected with Hepatitis B while 7% had both malaria and bacterial infection. The significance of this study is to highlight the fact that sickle cell patients who receive hydration therapy attain electrolyte balance within 24 h of re-hydration and therefore should not be over- enthusiastically challenged especially in those localities where there are no facilities for monitoring hydration therapy. In addition, the study revealed that malaria is the major precipitating cause of sickle cell crisis in Enugu, Nigeria and governments should take a holistic approach towards the fight against malaria.

Key words: Sickle cell anaemia, electrolytes, crisis, prevalent causes, malaria.