Asymmetric dimethylarginine levels in children with sickle cell disease and its correlation to tricuspid regurgitant jet velocity

作者：El Shanshory Mohamed^*; Badraia Ibrahim; Donia Amr; Abd El hameed Faten; Mabrouk Mokhtar

来源：European Journal of Haematology, 2013, 91(1): 55-61.

DOI：10.1111/ejh.12114

• sickle cell disease
• tricuspid regurgitant jet velocity
• asymmetric dimethylarginine

Background Pulmonary hypertension (PH) is an increasingly recognized life-threatening complication in sickle cell disease (SCD), with associated high mortality in adults. The prevalence of PH in children with SCD is still unknown. The etiology and pathophysiologic mechanisms are still not well understood. Aim of the study To assess the plasma levels of asymmetric dimethylarginine (ADMA) in children with SCD and its correlation with elevated tricuspid regurgitant jet velocity and other hemolytic markers. Subjects & Methods This study was carried out on a cohort of patients (30) with SCD and 30 healthy children as a control group. Certain investigations were carried out for all subjects: CBC, lactate dehydrogenase (LDH), ferritin, reticulocytic count, bilirubin, AST, ALT, and plasma levels of ADMA. Doppler echocardiography was carried out for all subjects. Results The prevalence of high tricuspid regurgitant velocity (TRV) was 30% in SCD patients. ADMA mean plasma level was significantly higher in patients than in controls (0.79 +/- 0.15mol/L and 0.46 +/- 0.11mol/L, respectively, P<0.001). ADMA was significantly higher in patients with high TRV than those with normal TRV (1.10 +/- 0.11mol/L, 0.80 +/- 0.06mol/L, respectively, P<0.001). There was a significant positive correlation between ADMA plasma levels and TRV 2.5m/s (r=0.475). Conclusion High plasma ADMA levels may be implicated in the pathogenesis of increased tricuspid regurgitant jet velocity in children with SCD.

• 出版日期2013-7