|
October
2023
- Volume 17, Issue 2
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
..............................................................................................................................................

..............................................................................................................................................
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
|
 |