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  • Title: Changes in platelet count as a predictive tool in sickle cell acute vaso-occlusive crises: a pediatric study.
    Author: Shanley LA, Ebeling M, Titus MO.
    Journal: Clin Pediatr (Phila); 2011 Jul; 50(7):657-61. PubMed ID: 21382920.
    Abstract:
    OBJECTIVE: Studies have shown that platelets play an important role in the pathophysiology of vaso-occlusive crises (VOC) in sickle cell disease. This study investigates whether changes in platelet indices from baseline can be predictive of complications during acute pain crisis. METHODS: Data were obtained from pediatric sickle cell patients in the well-clinic setting and compared with data gathered during VOC (n = 67). Primary outcome was complicated (admission, acute chest syndrome, transfusion, etc) versus uncomplicated (discharge from emergency department without subsequent return) course. RESULTS: Patients with uncomplicated courses had larger platelet declines (53.7) than those with complicated courses (14.8, P = .005). CONCLUSIONS: The study suggests that patients with uncomplicated VOC are more likely to experience a larger decline in platelets. The predictive value is limited by the need to have preexisting steady-state data and relatively small decline. Ongoing studies are needed to identify useful laboratory data to help predict severity of VOC.
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