Perfil nutricional e ósteo-articular de pacientes com doença falciforme acompanhados no Hemocentro Regional de Uberaba-MG

Abstract

Introduction: The vaso-occlusive phenomena, chronic hemolysis and inflammatory state are the main determinants of the clinical manifestations of sickle cell disease (SCD). The individuals affected present nutritional deficiency and osteo-articular manifestations of various etiologies. The objectives of this study were to describe the epidemiological, clinical, laboratorial, nutritional and osteo-articular profile of patients with SCD and to verify the existence of an association between nutritional and osteo-articular changes. Materials and methods: cross-sectional evaluation of 55 individuals with SS and Sβ SCD (Sβ0 and Sβ +), older than 14 years out of the crisis period, followed at the Uberaba Regional Hemocenter (HRU), through a clinical interview, evaluation of the locomotor system, anthropometry, laboratory tests, radiographic and Bone Mineral Densitometry (BMD). Results: 74.5% had SS hemoglobinopathy; 67.3% were female, 78.2% were black or brown, with a mean age of 30.5 ± 11.5 years. The majority (61.8%) reported up to 3 painful crisis per year with a high intensity prevalence (65.5%). Regarding nutritional classification, 7.3% presented low PGC, 45.6% adequate PGC and 47.3% high PGC. In the correlation with the epidemiological and clinical characteristics, there were statistically significant differences regarding sex, higher in females (p = 0.0021), age, higher in younger ones (p = 0.0400), and number of painful crisis per year, higher in those with fewer painful crisis (p = 0.0178). Prevalence reduced BMD (54.8%), with no statistical difference in relation to epidemiological and clinical characteristics. Radiographic changes were present in 80% of the participants, with 140 lesions identified, most of them in the spine, femur and shoulders, mainly osteonecrosis and osteoarthrosis. Most individuals with low PGC had no radiographic lesions (75.0%); the majority of those with adequate and high PGC presented between 1 and 4 lesions (72.0% and 61.5%, respectively). Conclusions: gender, age and number of painful crisis had a statistically significant association with PGC. No epidemiological or clinical features are associated with radiographic changes or BMD, which indicates that all individuals should be treated equally, with the best available therapy. PGC is not related to BMD, but tends to be associated with the amount of radiographic lesions in patients.