Ultrasonographic spleen size and haematological parameters in children with sickle cell anaemia in Kano, Nigeria.

AIMS AND OBJECTIVES

To determine spleen size using abdominal ultrasonography and haematological parameters in steady state children with sickle cell anaemia (SCA).

SUBJECTS AND METHODS

An analytical case control study of 150 children with SCA in steady state aged 6 months to 15 years was undertaken. Children with HbAA matched for sex and age were used as controls. The spleen sizes of children with SCA and the controls were determined using abdominal ultrasonography. Haematological parameters (RBC, Hb, MCV, MCH, MCHC,WBC, Platelet and Reticulocyte counts) were also assessed.

RESULTS

Fifty three children (35.3%) with SCA against 19 children (12.7%)with HbAA had splenomegaly defined as spleen index > 31cm². among the children with SCA who had splenomegaly, 17 (11.3%) were older than 10 years. None of those above 10 years with HbAA had splenomegaly. The mean values of RBC, Hb, MCV and MCH were significantly lower in children with SCA compared to age- sex matched HbAA controls (p = 0.001, 0.001, 0.15 and 0.016 respectively), while the mean values of MCHC, WBC, platelet and reticulocyte counts were significantly higher in children with SCA than in the HbAA controls (p = 0.022, 0.001, 0.013 and 0.001) respectively. Among the SCA subjects, as spleen index increased from grade II through grade V, the mean values of RBC, Hb, WBC and platelet count significantly decreased (p =0.001, 0.001, 0.032 and 0.007), while the mean value of reticulocyte count significantly increased (p = 0.001). However, with increasing spleen index from grade II to grade V, the mean values of MCV, MCH and MCHC were not significantly different (p = 0.077, 0.741 and 0.995).

CONCLUSION

Splenomegaly persists in much older age group in children with SCA and is associated with mild cytopaenia. Spleen size in children with SCA should be assessed using a more sensitive and reliable method of ultrasonography.