As a good prognostic sign, autosplenectomy is higher in females in sickle cell diseases

Mehmet Rami Helvaci1, Valeria Pappel2, Kubra Piral2, Selim Ozer2,
Mehpare Camlibel3, Huseyin Sencan1, Ramazan Davran4, Abdulrazak Abyad5,
Lesley Pocock6

(1) Specialist of Internal Medicine, MD, Turkey
(2) Manager of Writing and Statistics, Turkey
(3) Specialist of Emergency Medicine, MD, Turkey
(4) Specialist of Radiology, MD, Turkey
(5) Middle-East Academy for Medicine of Aging, MD, Lebanon
(6) edi-WORLD International, Australia

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

Received: August 2023; Accepted: September2023; Published: October 2023
Citation: Helvaci MR et al. As a good prognostic sign, autosplenectomy is higher in females in sickle cell diseases. Middle East Journal of Nursing 2023; 17(2): 24-38. DOI: 10.5742/MEJN2023.9378042

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ABSTRACT

Background: Sickle cell diseases (SCDs) are inborn and destructive processes on vascular endothelium, particularly at the capillaries.

Methods: All patients with the SCDs were included.

Results: We studied 222 males and 212 females with similar ages (30.8 vs 30.3 years, p>0.05, respectively). Although the higher prevalence of autosplenectomy (50.4% vs 53.3%, p<0.05), transfused units of red blood cells (RBCs) in their lives (48.1 vs 28.5, p=0.000), disseminated teeth losses (5.4% vs 1.4%, p<0.001), ileus (7.2% vs 1.4%, p<0.001), cirrhosis (8.1% vs 1.8%, p<0.001), leg ulcers (19.8% vs 7.0%, p<0.001), clubbing (14.8% vs 6.6%, p<0.001), coronary heart disease (CHD) (18.0% vs 13.2%, p<0.05), chronic renal disease (CRD) (9.9% vs 6.1%, p<0.05), chronic obstructive pulmonary disease (COPD) (25.2% vs 7.0%, p<0.001), and stroke (12.1% vs 7.5%, p<0.05) were all lower in females.

Conclusion: The sickled or just hardened RBCs-induced capillary endothelial damage initiates at birth, and terminates with multiorgan failures even at childhood. Although RBCs suspensions and corticosteroids in acute, and aspirin with an anti-inflammatory dose plus low-dose warfarin plus hydroxyurea both in acute and chronic phases decrease severity, survivals are still shortened in both genders, dramatically. Although the higher prevalence of autosplenectomy, transfused units of RBCs in their lives disseminated teeth losses, ileus, cirrhosis, leg ulcers, clubbing, CHD, CRD, COPD, and stroke were all lower in females. So there may be an inverse relationship between autosplenectomy and severity of SCDs, and spleen may act as a chronic inflammatory focus as a filter of blood for these sickled or just hardened RBCs.

Key words: Sickled or just hardened red blood cells, capillary endothelial edema, myocardial infarction, stroke, sudden deaths, autosplenectomy, female gender