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Sickle Cell Anaemia (SCA) management requires regular monitoring which is often challenging in resource-limited settings. This study explores the novel use of Platelet-Neutrophil Ratio (PNR) as a comprehensive monitoring tool in SCA. We present a case of a Jehovah's Witness child with SCA, managed with hydroxyurea for elevated transcranial Doppler (TCD) velocities. PNR was retrospectively analysed against clinical parameters over 18 months. PNR showed significant correlations with Packed Cell Volume (r=0.588, p=0.002), Mean Corpuscular Volume (r=0.739, p<0.0001), and a negative correlation with TCD velocity (r=-0.53, p=0.115). A positive correlation with Haemoglobin F (r=0.461, p=0.434) was also observed. Notably, PNR fluctuations corresponded with clinical status; lower values coincided with a vaso-occlusive crisis, while higher values were associated with stable condition and optimised hydroxyurea therapy. This case highlights PNR's potential as a valuable supplementary marker for routine SCA monitoring, particularly in resource-constrained environments. By providing a cost-effective means of assessing disease progression and predicting complications, PNR could significantly enhance patient outcomes. Further research is warranted to validate PNR's efficacy and establish comprehensive guidelines for its clinical integration, potentially revolutionising SCA management in low- and middle-income countries.
Nri-Ezedi et al. (Wed,) studied this question.