 |
|
Simple test could predict major complications in sickle cell patients
March 07, 2006Researchers have found that a simple test for an enzyme called LDH may have significant importance for determining major risk factors in adults with sickle cell disease. The study results will be published in the March 15, 2006, issue of Blood, the official journal of the American Society of Hematology.
"This study suggests that LDH testing may be a worthwhile addition to 'well adult' visits for individuals with sickle cell anemia, though the significance in children and adolescents, remains unclear," said Zora Rogers, MD, Associate Professor of Pediatrics at The University of Texas Southwestern Medical Center in Dallas, who is not affiliated with the study.
LDH, or lactate dehydrogenase, is found in many different types of cells in the body, but is particularly rich in the red blood cells, heart, kidney, liver, and muscles. When these organs become diseased, the cells containing LDH release the enzyme, resulting in elevated LDH levels in the bloodstream.
In this study, patients with all forms of sickle cell disease - 213 adults in all - had their LDH levels measured with a blood test. Based on these values, the patients were categorized into three groups - low, medium, and high LDH. The LDH values were then reviewed in light of each patient's medical history.
Typically, the upper limit of LDH in healthy adults is 200 IU/L (international units per liter). The 31 patients in the high group had LDH values of 512-1171 IU/L, correlating to a history of medical complications, in particular, leg ulcerations and priapism. The patients' LDH values were also compared to their rates and severity of pulmonary hypertension, a build-up of pressure in the arteries that supply the lungs and a common complication of sickle cell disease. The researchers found that LDH values rise with severity of pulmonary hypertension.
In addition, mortality rates for the study participants were examined over a follow-up period of 49 months. Researchers found that patients with LDH values higher than the median had reduced survival compared to those with LDH values lower than the median. These data suggest that high LDH values may predict early mortality in patients with sickle cell disease.
The results of the study indicate that high LDH levels can define a subgroup of sickle cell patients who are significantly more likely to have serious complications such as pulmonary hypertension, leg ulcerations, and priapism, and are at increased risk of early mortality. Interestingly, these correlations held whether or not patients were taking hydroxyurea, the standard treatment for the disease, and LDH values were not associated with episodes of pain crisis, the hallmark of sickle cell anemia.
The source of LDH in these patients appears to be primarily from the breakdown of fragile red blood cells, consistent with recent published findings suggesting that red blood cell contents released into the bloodstream over a period of years may cause diseased blood vessel walls.
"LDH levels illuminate a pattern of pathology in sickle cell disease patients," said Gregory Kato, MD, of the National Institutes of Health and lead study author. "As a result, LDH appears to hold great promise as an effective indicator for identifying patients most at risk and in need of possible preventive care and careful monitoring."
American Society of Hematology
In this study, patients with all forms of sickle cell disease - 213 adults in all - had their LDH levels measured with a blood test. Based on these values, the patients were categorized into three groups - low, medium, and high LDH. The LDH values were then reviewed in light of each patient's medical history.
Typically, the upper limit of LDH in healthy adults is 200 IU/L (international units per liter). The 31 patients in the high group had LDH values of 512-1171 IU/L, correlating to a history of medical complications, in particular, leg ulcerations and priapism. The patients' LDH values were also compared to their rates and severity of pulmonary hypertension, a build-up of pressure in the arteries that supply the lungs and a common complication of sickle cell disease. The researchers found that LDH values rise with severity of pulmonary hypertension.
In addition, mortality rates for the study participants were examined over a follow-up period of 49 months. Researchers found that patients with LDH values higher than the median had reduced survival compared to those with LDH values lower than the median. These data suggest that high LDH values may predict early mortality in patients with sickle cell disease.
The results of the study indicate that high LDH levels can define a subgroup of sickle cell patients who are significantly more likely to have serious complications such as pulmonary hypertension, leg ulcerations, and priapism, and are at increased risk of early mortality. Interestingly, these correlations held whether or not patients were taking hydroxyurea, the standard treatment for the disease, and LDH values were not associated with episodes of pain crisis, the hallmark of sickle cell anemia.
The source of LDH in these patients appears to be primarily from the breakdown of fragile red blood cells, consistent with recent published findings suggesting that red blood cell contents released into the bloodstream over a period of years may cause diseased blood vessel walls.
"LDH levels illuminate a pattern of pathology in sickle cell disease patients," said Gregory Kato, MD, of the National Institutes of Health and lead study author. "As a result, LDH appears to hold great promise as an effective indicator for identifying patients most at risk and in need of possible preventive care and careful monitoring."
American Society of Hematology
Sickle Cell Current Events and Sickle Cell News RSSChildren's Hospital study demonstrates how bone marrow transplant can cure sickle cell disease
A unique approach to bone marrow transplantation pioneered in part by a Children's Hospital of Pittsburgh of UPMC physician has proven to be the only safe and effective cure for sickle cell disease, according to a new study.
Children's national co-leads nationwide study of landmark sickle cell treatment
Children's National Medical Center immunologist and blood and marrow transplant physician Naynesh Kamani, MD, will serve as the study co-chair for a new national clinical trial of unrelated donor marrow and umbilical cord blood transplants for severe sickle cell disease.
Most generalists reluctant to provide primary care for young adults with chronic illness
The majority of general internists and pediatricians in the United States are not comfortable serving as primary care providers for young adults with complex chronic illnesses that originate during childhood, according to findings from a new national survey.
Consortium develops new method to manipulate genetic material
A multi-institutional team of researchers, including scientists at the University of Minnesota Medical School, have developed a powerful tool for genomic research and medicine.
Gaining ground on sickle cell disease
Although sickle cell disease is a single-gene disorder, its symptoms are highly variable. In a study published online July 14 by the Proceedings of the National Academy of Sciences, scientists at Children's Hospital Boston and the Dana Farber Cancer Institute (DFCI), in collaboration with the Broad Institute of MIT and Harvard, report five gene variants that could potentially be helpful in predicting sickle cell disease severity, perhaps even leading to better treatment approaches in the future.
Effective treatment for sickle cell underused by doctors
Uncertainties about proper use and possible long-term effects of hydroxyurea in the treatment of sickle cell anemia may be wrongly influencing doctors to avoid prescribing it to those in serious need, according to results of a literature review by specialists at Johns Hopkins.
Statistical tool could explain gene study variations
While scientists are using the human genome to associate certain genes with disease, Dr. Hongyan Xu wants to ensure they are accounting for natural variations in those genes.
Major 'missed' biochemical pathway emerges as important in virtually all cells
A new study by Duke University researchers provides more evidence that the nitric oxide (NO) system in the life of a cell plays a key role in disease, and the findings point to ways to improve treatment of illnesses such as heart disease and cancer.
For children with sickle cell disease, lung disease is part of the package
Children with sickle cell disease (SCD) have a significantly sharper decline in lung function with age when compared to other children of the same race and age.
Clumps of red and white blood cells may contribute to sickle cell disease
It's long been known that patients with sickle cell disease have malformed, "sickle-shaped" red blood cells - which are normally disc-shaped - that can cause sudden painful episodes when they block small blood vessels.
More Sickle Cell Current Events and Sickle Cell News Articles
 | Understanding Sickle Cell Disease (Understanding Health and Sickness Series) by Ph.D., Miriam Bloom |
 | Hope and Destiny: A Patient's and Parent's Guide to Sickle Cell Disease and Sickle Cell Trait by Allan F., Jr. Platt, Alan, M.D. Sacerdote An up-to-date, informative, and personal discussion of sickle-cell anaemia, this guide provides information on medically proven methods of treatment along with patient vignettes. Written primarily for African Americans, who comprise the majority of the victims of sickle-cell anaemia, this handbook for patients and those who live or work with them examines the complex issues that surround this... |
| Sickle Cell Disease (Just the Facts) by Oliver Gillie | |
 | In the Blood: Sickle Cell Anemia and the Politics of Race (Critical Histories) by Melbourne Tapper Although it strikes individuals from a variety of backgrounds, sickle cell anemia has always been known as a "black" disease in America. In the Blood argues that ever since the discovery in 1910 and subsequent scientific analysis of the disease, sickle cell anemia has been manipulated to serve social ends-as a tool for securing white identity and a way to establish a hierarchy based on European... |
 | Sickle-Cell Anemia Disease Medical Guide by Qontro Medical Guides The Sickle-Cell Anemia Disease Medical Guide is a publication which has been designed to better help readers understand Sickle-Cell Anemia Disease. This Qontro Medical Guide has been designed with the reader in mind, and is a useful information source for readers at all levels looking to learn more about Sickle-Cell Anemia Disease. The Sickle-Cell Anemia Disease Medical Guide is highly... |
 | Sickle Cell Disease (Diseases and Disorders) by Lizabeth Peak |
 | The Troubled Dream of Genetic Medicine: Ethnicity and Innovation in Tay-Sachs, Cystic Fibrosis, and Sickle Cell Disease by Keith Wailoo, Stephen Pemberton Why do racial and ethnic controversies become attached, as they often do, to discussions of modern genetics? How do theories about genetic difference become entangled with political debates about cultural and group differences in America? Such issues are a conspicuous part of the histories of three hereditary diseases: Tay-Sachs, commonly identified with Jewish Americans; cystic fibrosis, often... |
 | Sickle Cell Anemia (Genetic and Developmental Diseases and Disorders) by Judy Monroe Peterson |
 | The Sickle Cell Anemia Update (Disease Update) by Alvin Silverstein, Virginia B. Silverstein, Laura Silverstein Nunn |
 | Sickle Cell Anemia (What Does It Mean to Have?) This superb new series is designed to present the facts and promote awareness and understanding of conditions that many children learn to live with. Each book: - introduces a condition, examining its causes and effects - looks at control, medication and treatment - covers the help and support available - includes numerous real-life case studies - is written with the help and advice of key... |
| © 2008 BrightSurf.com |