Super-Elevated LDH and Thombocytopenia Are Markers Of An Unusual Sickle Phenomenon

Recurrent vaso-occlusive crisis (VOC) is a hallmark of sickle cell disease (SCD). Its pathobiology remains poorly understood. VOC occurs on a background of chronic haemolysis with lactate dehydrogenase (LDH), a key biomarker. In steady state, patients have elevated total LDH which becomes more elevated in VOC. Recent data from King's College Hospital (2009-10) shows LDH in VOC was significantly increased by 28% compared to steady state, from 379 +/- 155 IU/L in steady state to 507+/-272 IU/L in VOC. In the same population, platelet counts remained similar in VOC and steady state (363 +/-177x109/L versus 379+/-161x109/L, respectively).