Inflammatory markers in sickle cell disease during vaso-occlusive crisis

Sickle cell disease (SCD) is a monogenic blood disorder in which vaso-occlusive crises (VOC) are the main cause of hospitalization. Along with vascular adhesion, inflammation plays a central role in VOC. This study compared inflammatory and hematological markers in SCD patients during VOC and steady state, examined their association with outcomes such as hospital stay, acute chest syndrome (ACS), and mortality, and evaluated the impact of hydroxyurea. A total of 109 VOC patients admitted to the Department of General Medicine, VIMSAR, and 40 steady-state patients attending the outpatient clinic were included. Hematological (HbF, HbS, hemoglobin, WBC, neutrophils, platelets), biochemical (bilirubin, AST, ALT, urea, creatinine), and inflammatory markers (IL-6,CRP, ferritin, LDH, ESR) were measured. Data were analyzed using GraphPad Prism; comparisons were made by unpaired t-test and correlations by Pearson analysis. VOC patients showed significantly lower hemoglobin and higher WBC and neutrophil counts compared to controls. Inflammatory markers were markedly elevated during VOC: IL-6 (41.95 vs2.1 pg/mL), CRP (61.34 vs3.2 mg/L), ferritin (847.6 vs116.7 ng/mL), and LDH (1151.7 vs719.5 U/L). Platelet count and ESR did not differ significantly. Hydroxyurea use was associated with lower inflammatory marker levels. Inflammation strongly influences VOC severity and outcomes, and hydroxyurea mitigates this effect. Routine monitoring of inflammatory markers may support predicting course and management in SCD.