title: Pattern of hemolysis parameters and association with fetal hemoglobin in sickle cell anemia patients in steady state.
abstract: OBJECTIVE
  This study aimed to evaluate the influence of fetal hemoglobin (Hb F) on hemolysis biomarkers in sickle cell anemia patients.
  
  
  METHODS
  Fifty adult sickle cell anemia patients were included in the study. All patients were taking hydroxyurea for at least six months and were followed at the outpatient clinic of a hospital in Fortaleza, Ceará, Brazil. The control group consisted of 20 hemoglobin AA individuals. The reticulocyte count was performed by an automated methodology, lactate dehydrogenase and uric acid were measured by spectrophotometry and arginase I by enzyme-linked immunosorbent assay (ELISA). The presence of Hb S was detected by high-performance liquid chromatography. The level of significance was set for a p-value <0.05.
  
  
  RESULTS
  A significant increase was observed in the reticulocyte count and lactate dehydrogenase, uric acid and arginase I levels in sickle cell anemia patients compared to the control group (p-value <0.05). Patients having Hb F levels greater than 10% showed a significant decrease in the reticulocyte count, arginase I and lactate dehydrogenase. A significant decrease was observed in arginase I levels in patients taking hydroxyurea at a dose greater than 20mg/kg/day.
  
  
  CONCLUSIONS
  The results of this study show that sickle cell anemia patients have increases in the hemolysis biomarkers, lactate dehydrogenase, reticulocyte count, arginase I, uric acid and increases in Hb F can reduce the reticulocyte count and arginase I and lactate dehydrogenase levels.
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Juliane Almeida
authors.initials: JA
authors.lastname: Moreira
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Marília Rocha
authors.initials: MR
authors.lastname: Laurentino
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Rosângela Pinheiro Gonçalves
authors.initials: RP
authors.lastname: Machado
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Maritza Cavalcante
authors.initials: MC
authors.lastname: Barbosa
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Ronaldo Pinheiro
authors.initials: RP
authors.lastname: Gonçalves
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Amanda de Menezes
authors.initials: Ade M
authors.lastname: Mota
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Lilianne Brito da Silva
authors.initials: LB
authors.lastname: Rocha
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Alice Maria Costa
authors.initials: AM
authors.lastname: Martins
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Alcínia Braga
authors.initials: AB
authors.lastname: de Lima Arruda
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Iêda Pereira
authors.initials: IP
authors.lastname: de Souza
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil. Electronic address: romeliagoncalves@gmail.com.
authors.forename: Romélia Pinheiro
authors.initials: RP
authors.lastname: Gonçalves
keywords: Anemia; Biological markers; Fetal hemoglobin; Hemolysis; Sickle cell