Avascular necrosis may not have an atherosclerotic background in sickle cell diseases

Mehmet Rami Helvaci (1)
Hasan Yilmaz (2)
Atilla Yalcin (1)
Orhan Ekrem Muftuoglu (1)
Abdulrazak Abyad (3)
Lesley Pocock (4)

(1) Specialist of Internal Medicine, MD
(2) Specialist of Ear, Nose, and Throat Diseases, MD
(3) Middle-East Academy for Medicine of Aging, MD
(4) medi-WORLD International

Corresponding author:
Prof Dr Mehmet Rami Helvaci,
07400, ALANYA, Turkey
Phone: 00-90-506-4708759
Email: mramihelvaci@hotmail.com

Received: June 2021; Accepted: July 2021; Published: August, 2021
Citation: Mehmet Rami Helvaci et al. Avascular necrosis may not have an atherosclerotic background in sickle cell diseases.
Middle East Journal of Nursing 2021; 15(3): 13-23.DOI: 10.5742/MEJN2021.9378011

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ABSTRACT

Background: We tried to understand whether or not there is a significant association between avascular necrosis (AVN) and atherosclerosis in sickle cell diseases (SCD).

Methods: All patients with the SCD were included.

Results: The study included 434 patients (212 females) with similar mean ages in male and female genders (30.8 versus 30.3 years, respectively, p>0.05). Smoking (23.8% versus 6.1%, p<0.001) and alcohol (4.9% versus 0.4%, p<0.001) were higher in male gender, significantly. Transfused units of red blood cells (RBC) in their lives (48.1 versus 28.5, p=0.000) were also higher in male gender, significantly. Similarly, disseminated teeth losses (<20 teeth present) (5.4% versus 1.4%, p<0.001), chronic obstructive pulmonary disease (COPD) (25.2% versus 7.0%, p<0.001), ileus (7.2% versus 1.4%, p<0.001), cirrhosis (8.1% versus 1.8%, p<0.001), leg ulcers (19.8% versus 7.0%, p<0.001), digital clubbing (14.8% versus 6.6%, p<0.001), coronary heart disease (CHD) (18.0% versus 13.2%, p<0.05), chronic renal disease (CRD) (9.9% versus 6.1%, p<0.05), and stroke (12.1% versus 7.5%, p<0.05) were all higher in male gender but not AVN (24.3% versus 25.4%, p>0.05), significantly.

Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of hardened RBC into the tissues. Although the higher smoking and alcohol-like strong atherosclerotic risk factors and disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, and stroke-like obvious atherosclerotic consequences in male gender, AVN was not higher in them, significantly. In another definition, AVN may not have an atherosclerotic background in the SCD.

Key words: Sickle cell diseases, chronic endothelial damage, atherosclerosis, avascular necrosis, male gender, smoking, alcohol