Markers of endothelial dysfunction differ between subphenotypes in children with sickle cell disease.

Abstract:

:In adult patients with sickle cell disease two distinct subphenotypes have previously been defined: patients with the viscosity-vaso-occlusion subphenotype (VVO) suffer mainly from vaso-occlusive pain crises and have a relatively high hemoglobin concentration. Patients classified as the hemolysis-endothelial dysfunction subphenotype (HED) suffer from stroke and pulmonary hypertension and have an elevated concentration of lactate dehydrogenase. However, this classification is not possible in children due to low rates of complications. We used laboratory markers to classify children into the two subphenotypes, and measured vWF and vWF propeptide as markers of endothelial dysfunction. We included 106 children with sickle cell disease (mean age 8.7years), 74 (70%) with HbSS/HbSβ° genotype and 32 (30%) with HbSC/HbSβ(+) genotype. vWF and vWF propeptide were significantly elevated in patients with sickle cell disease; this was more pronounced in patients with the HbSS/HbSβ° genotype. Patients with the HED subphenotype had higher levels of vWF propeptide, and a trend towards higher levels of vWF compared to those with the VVO subphenotype. We demonstrated that even young children in a stable clinical condition show signs of persistent endothelial dysfunction. A prospective study should demonstrate whether elevated levels of vWF and its propeptide are associated with an increased risk of complications specific for the HED subphenotype.

journal_name

Thromb Res

journal_title

Thrombosis research

authors

van der Land V,Peters M,Biemond BJ,Heijboer H,Harteveld CL,Fijnvandraat K

doi

10.1016/j.thromres.2013.10.006

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

712-7

issue

6

eissn

0049-3848

issn

1879-2472

pii

S0049-3848(13)00462-3

journal_volume

132

pub_type

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