Erythrocyte sedimentation rate during steady state, painful crisis and infection in children with sickle cell disease

OBJECTIVE: To evaluate Erythrocyte Sedimentation Rate in children with sickle cell disease.

METHODS: Erythrocyte Sedimentation Rate was performed in 95 children with sickle cell disease during the period from December 1992 to June 1999. Patients were classified into 4 groups. Patients in the steady state (group 1), painful crisis (group 2), mild infection (group 3) and moderate/severe infection (group 4). Comparison between the groups was performed using ANOVA and ANCOVA.

RESULTS: There were 55 males (58%) and 40 females (42%) with a mean age of 79.1 months. The mean Erythrocyte Sedimentation Rate values for the various groups were as follows: Group 1 (n=10); mean Erythrocyte Sedimentation Rate is 5 mm/hr (+/-4.6) and was significantly the lowest (p<0.05), group 2 (n=44); mean Erythrocyte Sedimentation Rate is 25.8 mm/hr (+/-16.3), group 3 (n=18); mean Erythrocyte Sedimentation Rate is 28.1 mm/hr (+/-25.8), while group 4 (n=23); mean Erythrocyte Sedimentation Rate is 99.2 mm/hr (+/-33.5) and was significantly the highest (p<0.05). Two cut-off values for the Erythrocyte Sedimentation Rate (>/- 30 mm/hr then >/- 50 mm/hr) were considered to evaluate their specificity and sensitivity for moderate/severe infection.

CONCLUSION: Although the Erythrocyte Sedimentation Rate is low in sickle cell disease, it does increase during painful crisis and infection and it is a useful indicator of moderate/severe infection.