Neutrophil-to-Lymphocyte Ratio in Pediatric Sickle Cell Anemia: A Case-Control Study from Gezira State, Sudan
Abstract
Background: Sickle Cell Anemia (SCA) is a common hereditary hemoglobinopathy marked by chronic intravascular hemolysis, recurrent microvascular occlusion, and sustained systemic inflammation.Objective: This study evaluated the clinical utility of the Neutrophil-to-Lymphocyte Ratio (NLR) as an accessible inflammatory biomarker among pediatric SCA patients in Sudan and examined its relationships with disease manifestations, clinical crisis phenotypes, and therapeutic regimens.Methods: A hospital-based case-control investigation was conducted at Wad Medani Pediatric Teaching Hospital in Gezira State, Sudan, enrolling 130 pediatric participants (80 confirmed SCA cases and 50 healthy controls). A formal sample size calculation was performed to ensure statistical power (>80%). Automated complete blood counts were performed using a Sysmex XP-300 hematology analyzer to calculate absolute NLR values. Statistical comparisons, ROC diagnostic evaluations, and stratified subgroup analyses were performed using SPSS version 22.Results: Pediatric SCA patients exhibited significantly elevated mean NLR compared with healthy controls (3.89 ± 2.60 vs. 1.56 ± 0.29, p 2.2. NLR levels varied markedly by clinical crisis category (p = 0.001), peaking during hand-foot syndrome (6.84 ± 1.66) and acute infection (5.00 ± 3.06). However, subgroup comparisons involving rare complications (such as acute chest syndrome, n=2, and cerebrovascular accident, n=2) require cautious interpretation due to limited…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 130 participants or records.
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