Gender differences in the complications of sickle cell anemia

Abstract

Background: The clinical severity of sickle cell anemia (SCA) varies from one individual to another. Several factors, including genetic predisposition, environmental and social factors, are known to modify the clinical presentation and complications of SCA but not much is known about the influence of gender. Objective: This study aims at determining the gender differences in the pattern of SCA complications in Enugu, Nigeria. Materials and Methods: This is a retrospective analysis of clinical and laboratory data from the folders of patients with SCA at the University of Nigeria Teaching Hospital Enugu, Nigeria between February 2008 and February 2014. A total of 248 folders comprising 151 males and 97 females were retrieved. Data on the age, sex, hematological parameters, number of complications, and frequency of SCA crises were extracted and analyzed. Only the case files of adult patients with SCA were investigated. Results: The median age of the participants was 25 (IQR = 22–30) years. The male to female ratio was 1.5:1. A total of 182 out of 248 (73.4%) cases reviewed had one form of complication or the other. Sickle cell leg ulcer was the most common complication seen among the cases (50/182 [27.5%]), followed by avascular necrosis (AVN) (28/182 [15.4%]). The mean frequency of crises was not different between the male and female genders (15.00 ± 9.01 vs. 9.8 ± 6.97; P = 0.293). However, the male gender had more complications than the female gender (116/151 [73.9%] vs. 116/151 [73.9%]; odds ratio [OR] = 2.13; 95% confidence interval [CI] = 1.2–3.7; P = 0.007). Conclusion: The male gender is twice more likely to develop complications of SCA and, thus, are more likely to have more morbidity from this condition.

Keywords

• complications
• sickle cell anaemia
• sickle leg ulcer
• vaso-occlusive crises