Smoking and sickle cell diseases

Abstract

Background: We tried to understand whether or not there is an association between higher prevalence of smoking and autosplenectomy in sickle cell diseases (SCDs) cases. Methods: All SCDs patients with and without autosplenectomy were studied, and they were compared in between. Results: The study included 253 patients (124 females). There were 168 cases (66.4%) with autosplenectomy and 85 cases (33.5%) without (p<0.001). Autosplenectomy cases were significantly elder than the others (30.7 versus 25.7 years, p= 0.000). Female ratios were similar in both groups (p>0.05). Thalassemia minors were significantly higher in cases without autosplenectomy (91.7% versus 50.0%, p<0.001). Interestingly, prevalence of smoking was significantly higher in cases with autosplenectomy (16.6% versus 9.4%, p<0.05). The mean units of transfused red blood cells (RBCs) and painful crises per year were similar in both groups (p>0.05 for both). Both the white blood cell and platelet counts of the peripheric blood were higher in cases with autosplenectomy, significantly (p = 0.000 for both), whereas the mean hematocrit value was significantly lower in them (p= 0.000). On the other hand, prevalences of digital clubbing, pulmonary hypertension, leg ulcers, chronic renal disease, coronary heart disease, and rheumatic heart disease were significantly higher in cases with autosplenectomy (p<0.05 for all). Conclusion: Due to the strong atherosclerotic background of smoking and SCDs, there may be an association between higher prevalence of smoking and clinical severity of the SCDs, and the spleen, as a filter of blood for the abnormally hard RBCs, may strongly be affected in smoker patients with SCDs.