A STUDY OF ANTITHROMBIN III IN HOMOZYGOUS SICKLE CELL ANAEMIA PATIENTS IN UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, MAIDUGURI, BORNO STATE NIGERIA

Abstract

Background: Sickle cell anaemia (SCA) is a genetic disorder which can be complicated by
haemolytic, vaso-occlusive and thrombotic processes. Antithrombin III (ATIII) is a naturally
occurring anticoagulant with anti inflammatory properties.
The objective of this study was to determine the level of ATIII in individuals with SCA and to
assess its role in vaso-occlusive crisis.
Methods: This was an observational cross sectional study in which 60 adult HbSS (34 in steady
state and 26 in vaso-occlusive crisis) subjects and 60 apparently healthy sex and age matched
controls were recruited. Haemoglobin (Hb) electrophoresis of subjects and controls was
determined using Hb electrophoresis. Nine and a half (9.5) milliliters of blood, divided into two
aliquots of 4.5mls (in 0.5mls of tri sodium citrate for coagulation studies) and 5mls (in EDTA
containing bottle for full blood count) was obtained. Quantitative assessment of antithrombin III
by chromogenic assay with Factor Xa was carried out using Diachrom ATIII test kit.
Prothrombin time, Activated partial thromboplastin time, Haematocrit, Total WBC and Platelet
count were assessed using standard protocol. SPSS (version 13 for windows) was used for data
analysis. A p value of <0.05 was considered significant.
Results: The subjects were made up of 33(55%) males and 27(45%) females, with a mean age of
22.52(5.21) years whilst the controls consisted of 34(56.7%) males and 26(43.3%) females with
a mean age of 22.85 (4.20). HbS subjects had a significantly lower ATIII levels compared to
controls (p=0.009), with a prevalence of 18.33% and 1.67% for ATIII deficiency respectively.
Levels of ATIII did not differ significantly in steady state and vaso-occlusive crisis (p=0.468).
Haematocrit was significantly lower in HbS than controls (p=0.000), whereas total WBC count,
absolute platelet count and Prothrombin Time were significantly higher in the HbS subjects.

Conclusion: The prevalence of low plasma ATIII is commoner in HbS subjects compared to age
and sex matched healthy controls. However, ATIII levels did not differ significantly between
steady state and vaso-occlusive crisis, suggesting that ATIII does not play a role in pathogenesis
of vaso-occlusive crisis.

A STUDY OF ANTITHROMBIN III IN HOMOZYGOUS SICKLE CELL ANAEMIA PATIENTS IN UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, MAIDUGURI, BORNO STATE NIGERIA