An Integrated Haemolysis–Inflammation–Haemostasis Signature across Clinical States of Sickle Cell Anaemia: A Comparative Biomarker Study

Abstract

Background: Sickle cell anaemia involves interconnected haemolytic, inflammatory, and haemostatic disturbances that may persist beyond overt crisis. Aims: To compare a combined five-parameter profile—lactate dehydrogenase (LDH), C-reactive protein (CRP), prothrombin time (PT), international normalised ratio (INR), and activated partial thromboplastin time (referred to locally as PTTK)—across patients with sickle cell anaemia in steady state, patients in crisis, and healthy controls, and to consider its relevance to transfusion practice. Methods: A comparative cross-sectional study enrolled 161 adults at the Haematology Day-care Unit, University College Hospital, Ibadan: 60 asymptomatic steady-state patients, 41 patients admitted with crisis, and 60 apparently healthy HbAA controls. Lactate dehydrogenase, C-reactive protein, prothrombin time, international normalised ratio, and PTTK were compared using one-way ANOVA with Bonferroni post hoc analysis and chi-square testing. Results: All five parameters were significantly deranged in both sickle cell groups relative to AHI (P < .001 for each), and none differed significantly between ASS and Bed. Mean LDH was 831.2 U/L in ASS and 811.4 U/L in Bed, compared with 165.7 U/L in AHI; CRP was high in 86.7% of ASS and 97.6% of Bed, compared with none of the AHI group; and PT, INR, and PTTK were each similarly prolonged in both sickle cell groups. Conclusion: The combined profile distinguished sickle cell anaemia from health but did not distinguish steady state from crisis. Longitudinal studies are needed to determine its clinical and transfusion-related utility.