Thrombomodulin and Lactate Dehydrogenase as Potential Predictors of Leg Ulcers in Sickle Cell Disease

Abstract

A bstract Background: Endothelial dysfunction, hypercoagulability, hemolysis, and vasculopathy are involved in the pathogenesis of sickle cell leg ulcers (SCLUs). Understanding these processes is crucial for developing effective strategies to manage and prevent SCLU. Objectives: To evaluate the plasma levels of thrombomodulin (TM) in patients with SCLU, determine if TM levels have any association with SCLU and its severity, and determine if TM has any association with markers of hemolysis. Materials and Methods: This was a cross-sectional analytical study carried out among patients with SCLU and their age-matched sickle cell disease (SCD) patients without leg ulcers. Venous blood samples were collected for the determination of TM and lactate dehydrogenase (LDH) levels. Statistical significance across means was determined using independent t tests and the one-way analysis of variance (ANOVA). Pearson’s correlation and linear regression analysis were used to determine the relationship between variables. Results: Of the 82 patients with SCD, 41 had SCLU (test group), and 41 had no SCLU (control group). Their mean age was 33.3 ± 9.0 and 33.0 ± 8.5 ( P = 0.30), respectively. There was no significant statistical difference between plasma levels of TM and number ( P = 0.191) and severity ( P = 0.148) of SCLU. Seventy-three (89%) SCD patients had LDH concentration above the reference limit of normal, and 9 (11%) were within normal limits ( P = 0.002). None of the test (SCLU) group patients had normal LDH values. Conclusion: SCLU is associated with higher levels of LDH, whereas plasma TM levels showed no association with the occurrence and severity of SCLU.