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Year : 2018  |  Volume : 43  |  Issue : 3  |  Page : 115-118

Effect of homocysteine and folic acid on vaso-occlusive crisis in children with sickle cell disease

1 Department of Clinical Biochemistry, Liver Institute, Menoufia University, Menoufia, Egypt
2 Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
3 Department of Molecular Diagnostics and Therapeutics, Genetic Engineering and Biotechnology Research Institute, University of Sadat City, Sadat, Egypt

Correspondence Address:
Ahmed M Badr
Pediatrics Department, Faculty of Medicine, Cairo University, 12613
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejh.ejh_1_18

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Introduction Vaso-occlusion is a determinant for most manifestations of sickle cell anemia (SCA). Elevated concentration of homocysteine contributes to thrombosis, a frequent event in SCA. Folic acid deficiency leads to increase in plasma homocysteine. The aim of study was to test whether children with SCA have elevated serum homocysteine with diminished folate level and to determine whether hyperhomocysteinemia has a correlation with the frequency of vaso-occlusive crisis. Patients and methods A case–control study was carried over a period of 1 year (January to December 2014) in the hematology clinic, Abo El-Reesh Hospital, Cairo University. A total of 50 patients with SCA were included together with 30 age-matched and sex-matched healthy children recruited from Menoufia Hospital. Venous blood samples were obtained from both groups to measure serum homocysteine and folic acid levels. Results The mean±SD of age of the patients and controls were 6.20±2.55 and 6.03±2.64 years, respectively. Homocysteine level was significantly higher in the patients group compared with control group, with a mean±SD of 44.68±9.096 and 18.81±3.76 µmol/l, respectively (P>0.01). Folic acid level was lower in the patients group than control group, with 12.02±2.76 and 14.68±2.99 ng/ml, respectively (P<0.05). Significant inverse correlation was found between homocysteine and folic acid (correlation coefficient −0.337 and P=0.017). A strong positive correlation between homocysteine level and the frequency of vaso-occlusive crisis was found (P=0.04). Conclusion Patients with sickle cell disease have high serum homocysteine with low folate levels. This hyperhomocysteinemia is positively correlated with the frequency of vaso-occlusive crisis.

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