Leukocyte counts in children with sickle cell disease. Comparative values in the steady state, vaso-occlusive crisis,...

Area of Science:

• Pediatrics
• Hematology
• Infectious Diseases

Background:

• Sickle cell hemoglobinopathies are genetic blood disorders affecting red blood cells.
• Accurate identification of bacterial infections in these children is crucial for timely treatment.
• Leukocyte counts are commonly used as indicators of infection, but their interpretation in sickle cell disease requires specific understanding.

Purpose of the Study:

• To evaluate the utility of total and differential white blood cell (WBC) counts in identifying bacterial infections in children with sickle cell hemoglobinopathies.
• To compare WBC counts during steady state, vaso-occlusive crisis, and bacterial infection.

Main Methods:

• Total and differential WBC counts were analyzed in 88 children with sickle cell hemoglobinopathies.
• Data were collected during three distinct clinical states: steady state, vaso-occlusive crisis, and active bacterial infection.
• Statistical analysis focused on identifying significant differences in leukocyte values across these states.

Main Results:

• Steady-state leukocyte values were found to be lower than previously reported.
• Both total and segmented leukocyte counts significantly increased during vaso-occlusive crisis and infection.
• A consistent and significant increase in band or nonsegmented leukocytes was observed specifically during bacterial infections (mean 4,580/microliter).

Conclusions:

• Total and differential WBC counts are valuable tools for identifying children with sickle cell hemoglobinopathies who have potentially serious bacterial infections.
• The specific pattern of increased band neutrophils during bacterial infection aids in differentiating it from other conditions like vaso-occlusive crisis.
• These findings support the use of leukocyte counts in the diagnostic workup of febrile episodes in children with sickle cell disease.