Pulmonary hypertension among 5 to 18 year old children with sickle cell anaemia in Nigeria

<div><p>Background</p><p>Pulmonary hypertension (PHT) is a significant cause of mortality in patients with sickle cell disease (SCD). Few studies on PHT in SCD have been carried out in children. This study aimed to estimate the prevalence of PHT in children with sickle cell anaemia (SCA) and determine its clinical and laboratory correlates.</p><p>Methods</p><p>In this cross sectional study, evaluation involved obtaining bio-data, history and physical examination findings in 175 SCA subjects with haemoglobin genotype SS aged 5 to 18 years and 175 age and sex matched controls with haemoglobin genotype AA. PHT was determined using peak Tricuspid Regurgitant Velocity (TRV) obtained from echocardiography as a marker. Complete blood count (CBC), lactate dehydrogenase (LDH) assay, reticulocyte count, foetal haemoglobin (HbF) estimation as well as Human Immunodeficiency Virus (HIV) I and II, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) screening were done for patients with SCA.</p><p>Results</p><p>The mean peak TRV of subjects with SCA and controls was 2.2 ± 0.4 m/s and 1.9 ± 0.3 m/s respectively and prevalence of PHT among children with SCA and controls was 22.9% and 2.3% respectively. PHT in SCA correlated negatively with body mass index, haematocrit and haemoglobin.</p><p>Conclusion</p><p>This study affirms that PHT prevalence is high in children with SCA in Nigeria. Cardiovascular examination for signs of PHT is recommended for children with SCA and if required, further echocardiographic assessment from as early as five years.</p></div

Independent variables associated with PHT.

<p>Independent variables associated with PHT.</p

Flow chart showing recruitment of SCA subjects.

<p>Flow chart showing recruitment of SCA subjects.</p

Prevalence of pulmonary hypertension in SCA subjects and controls.

<p>Prevalence of pulmonary hypertension in SCA subjects and controls.</p

Comparison of laboratory parameters of SCA subjects with and without PHT.

<p>Comparison of laboratory parameters of SCA subjects with and without PHT.</p

Flow chart showing recruitment of control subjects.

<p>Flow chart showing recruitment of control subjects.</p

Box plots depicting TRV values among SCA subjects and controls.

<p>Box plots depicting TRV values among SCA subjects and controls.</p

Clinical findings of SCA subjects with and without PHT.

<p>Clinical findings of SCA subjects with and without PHT.</p

Demography and anthropometry of study population.

<p>Demography and anthropometry of study population.</p

Age distribution of SCA subjects with and without PHT.

<p>Age distribution of SCA subjects with and without PHT.</p