Abstract

EVALUATION OF VONWILLIEBRAND FACTOR LEVELS IN SICKLE CELL DISEASE PATIENTS WITH LEG ULCERS IN SOUTHSOUTH NIGERIA

Urhie O.O., Awodu O., Okuonghae M.E.*, Dirisu M.I., Awotiku O.O., Ibhayehor J.O.

Abstract

Background: Leg ulcers contribute to significant morbidity in patients with sickle cell disease (SCD). Nigeria has the highest burden of SCD with about one-third of the patients having leg ulcers. Although several factors contribute to the development of leg ulcer, the role of Von Willebrand factor (VWF) has not been adequately explored globally. Aim: This study aimed at determining the levels of VWF in SCD patients with leg ulcers in Benin City, Nigeria. Methods: This was a hospital based comparative study conducted at the University of Benin Teaching hospital (UBRH) between June 2023 and November 2023 among SCD patients and healthy controls. Eighty-eight subjects including 33 SCD patients with leg ulcer, 33 SCD patients without leg ulcers and 22 Haemoglobin (Hb) AA controls were recruited. Blood samples were analyzed for VWF, full blood count (FBC), Prothrombin time (PT) and Activated partial thromboplastin time (APTT). FBC parameters were estimated using an auto analyser (Sysmex Haematology Autoanalyser model KN21. Coagulation parameters (PT and APTT) were estimated manually and VWF concentration was estimated using the enzyme linked immunosorbent assay method (ELISA). Human von Willebrand Factor ELISA Kit (Cat: ELK5248) was used. Data were analyzed using the statistical package for social sciences (SPSS) version 23. Results: The mean age (SD) of SCD patients with leg ulcers, SCD controls and HbAA controls were 29±6.6yrs, 29.3±5.9yrs and 29.9±6.7yrs respectively. The differences in mean age across the study groups were not statistically significant (p=0.932). The peak age range of SCD patients with leg ulcer was 25- 29 years. 14 (57.6%) individuals with SCD with leg ulcers were females and 14 (42.4%) were males. There was no statistically significant difference in the sex distribution between the case group and controls (p=0.521). The median VWF levels was higher in SCLU and SCD control groups compared to age and sex matched HbAA controls (2.56ng/ml, 2.09ng/ml and 2.00ng/ml respectively). The differences in median were not statistically significant (p= 0.273). The study did not find any significant association between the levels of VWF and the severity of leg ulcer (p=00.321). Conclusion: There was no significant association between VWF levels and SCLU in our study population.

Keywords: Vonwilliebrand factor, sickle cell disease, leg ulcer, Nigeria.