Laboratory and echocardiography markers in sickle cell patients with leg ulcers

Chronic leg ulcers are a debilitating complication of sickle cell disease, associated with increased morbidity and perhaps mortality that affect 8 to 50% of patients. We evaluated the characteristics of SCD patients with a history of leg ulceration, including hemolytic rate, estimated pulmonary artery systolic pressure, and other parameters in a cohort of 505 adults with SCD. Ninety four subjects (18%) had either active ulcers at enrollment or history of leg ulceration. Patients affected were older and predominantly had homozygous SS, lower body mass index, and pulse oximetry, higher tricuspid regurgitation velocities, markers of hemolysis, serum uric acid and serum NT-proBNP, when compared to subjects without such history. In this prospective cohort of adults with SCD, we confirm that leg ulcers are still frequent and are associated with elevated TRVand markers of hemolysis. We describe a novel association of leg ulcer with hyperuricemia and oxygen desaturation and suggest potential implications for uric acid as a marker of vascular dysfunction.