Level of fetal hemoglobin as an indicator of clinical complications in sickle cell anemia

RESUMO

The fetal hemoglobin (HbF) level was used as an indicator of the development of severe clinical complications in 89 patients with sickle cell anemia (SCA). HbF was determined by the alkali denaturation technique. The mean HbF level was 6.7 + or - 4.2% (range, 0.7 to 19.2%) of total hemoglobin. Major organ failures were considered to be teerminal events of morbidity and included 8 cerebrovascular accidents, 13 aseptic necroses of the femoral head and 17 leg ulcer episodes. The characteristics of the test, including sensitivity, specificity and positive predictive value were analyzed for different levels of HbF. The overall specificities were 76,76, and 85% for HbF levels >=8,10 and 12%, respectively. The sensitivity of the test was low. The positive predictive value reached 71% for children with HbF >=8%. The data suggest that HbF level may be a useful indicator of the possibility of a patient developing serious clinical complications