Prognostic significance of plasma bilirubin in sickle cell diseases

Background: Total bilirubin value of the plasma may have prognostic significance in sickle cell diseases (SCD).Methods: All patients with the SCD were included between March 2007 and June 2016.Results: We studied 253 patients (128 females) with a plasma bilirubin value of lower than 5.0 mg/dL and 109 patients (43 females) with a value of 5.0 mg/dL and higher.There were 31 deaths during the ten-year period (14 females with a mean age of 33.3 and 17 males with a mean age of 30.2 years, p>0.05).Although the similar mean ages (30.2 versus 31.7 years, p>0.05), male ratio (60.5% versus 49.4%, p<0.05), ileus (3.9% versus 10.0%, p<0.01), digital clubbing (6.3% versus 26.6%, p<0.001), leg ulcers (12.2% versus 20.1%, p<0.05), pulmonary hypertension (9.4% versus 23.8%, p<0.001), cirrhosis (1.5% versus 15.5%, p<0.001), chronic renal disease (CRD) (6.7% versus 12.8%, p<0.05), and exitus (4.7% versus 11.9%, p<0.001) were all higher in patients with the plasma bilirubin value of 5.0 mg/dL and higher.Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level and terminate with accelerated atherosclerosis induced end-organ failures in early years of life.Total bilirubin value of the plasma may have prognostic significance due to the higher prevalence of ileus, digital clubbing, leg ulcers, pulmonary hypertension, cirrhosis, CRD, and exitus in patients with the plasma bilirubin value of 5.0 mg/dL and higher.The higher bilirubin values may either show the severity of hemolytic process initiated at birth or an advanced hepatic involvement in such cases.