Biomarkers in the major complications of SCD
| . | Type . | Biomarker . |
|---|---|---|
| Vaso-occlusive pain crisis | Physiological | Age |
| Routine laboratory | High hemoglobin, low fetal hemoglobin (HbF), coinheritance of α-thalassemia, hypovitaminosis D | |
| Molecular | Elevated thrombospondin 1 and soluble VCAM, decreased apelin/endothelin 1 ratio | |
| ACS and MOFS | Physiological | Age, airway hyperresponsiveness, aeroallergen sensitization |
| Routine laboratory | High baseline hemoglobin, low fetal hemoglobin (HbF), leukocytosis, acute thrombocytopenia (risk factor for multiorgan failure) | |
| Molecular | Secretory phospholipase A2 | |
| Pulmonary fibrosis | Molecular | Circulating fibrocytes |
| Primary ischemic stroke | Physiological | Relative systolic hypertension |
| Routine laboratory | Low baseline hemoglobin, low fetal hemoglobin (HbF), leukocytosis, absence of α-thalassemia | |
| Imaging | Elevated carotid blood velocity by TCD, presence of silent cerebral infarcts, Moyamoya syndrome | |
| Hemorrhagic stroke | Imaging | Moyamoya syndrome, saccular aneurysms |
| Cognitive impairment | Routine laboratory | Lower baseline hemoglobin |
| Pulmonary hypertension | Physiological | 6-min walk test distance <333 m |
| Routine laboratory | NT-proBNP >166 pg/mL | |
| Imaging | Elevated TRV | |
| Kidney dysfunction | Physiological | Hypertension, impaired nocturnal systolic blood pressure dipping |
| Routine laboratory | Microalbuminuria, hemoglobinuria | |
| Molecular | Cystatin C, NAG, and proximal tubular trans-membrane protein urinary KIM-1 | |
| Papillary infarction | Routine laboratory | Hematuria |
| Hemosiderosis | Routine laboratory | Hyperferritinemia |
| Imaging | Elevated liver and cardiac MRI | |
| Acute hepatopathy | Imaging | Increased liver stiffness by transient elastography |
| Pregnancy complications | Molecular | Placental growth factor |
| Increased disease severity and mortality | Routine laboratory | Baseline hemoglobin <7 g/dL, low fetal hemoglobin (HbF), leukocytosis at baseline, G6PD deficiency, reticulocytosis, high TCD velocity |
| Imaging | TRV >2.5 m/s | |
| Decreased disease severity and mortality | Routine laboratory | Coinheritance of α-thalassemia |
| Molecular | Senegal and Arab-Indian haplotypes |
| . | Type . | Biomarker . |
|---|---|---|
| Vaso-occlusive pain crisis | Physiological | Age |
| Routine laboratory | High hemoglobin, low fetal hemoglobin (HbF), coinheritance of α-thalassemia, hypovitaminosis D | |
| Molecular | Elevated thrombospondin 1 and soluble VCAM, decreased apelin/endothelin 1 ratio | |
| ACS and MOFS | Physiological | Age, airway hyperresponsiveness, aeroallergen sensitization |
| Routine laboratory | High baseline hemoglobin, low fetal hemoglobin (HbF), leukocytosis, acute thrombocytopenia (risk factor for multiorgan failure) | |
| Molecular | Secretory phospholipase A2 | |
| Pulmonary fibrosis | Molecular | Circulating fibrocytes |
| Primary ischemic stroke | Physiological | Relative systolic hypertension |
| Routine laboratory | Low baseline hemoglobin, low fetal hemoglobin (HbF), leukocytosis, absence of α-thalassemia | |
| Imaging | Elevated carotid blood velocity by TCD, presence of silent cerebral infarcts, Moyamoya syndrome | |
| Hemorrhagic stroke | Imaging | Moyamoya syndrome, saccular aneurysms |
| Cognitive impairment | Routine laboratory | Lower baseline hemoglobin |
| Pulmonary hypertension | Physiological | 6-min walk test distance <333 m |
| Routine laboratory | NT-proBNP >166 pg/mL | |
| Imaging | Elevated TRV | |
| Kidney dysfunction | Physiological | Hypertension, impaired nocturnal systolic blood pressure dipping |
| Routine laboratory | Microalbuminuria, hemoglobinuria | |
| Molecular | Cystatin C, NAG, and proximal tubular trans-membrane protein urinary KIM-1 | |
| Papillary infarction | Routine laboratory | Hematuria |
| Hemosiderosis | Routine laboratory | Hyperferritinemia |
| Imaging | Elevated liver and cardiac MRI | |
| Acute hepatopathy | Imaging | Increased liver stiffness by transient elastography |
| Pregnancy complications | Molecular | Placental growth factor |
| Increased disease severity and mortality | Routine laboratory | Baseline hemoglobin <7 g/dL, low fetal hemoglobin (HbF), leukocytosis at baseline, G6PD deficiency, reticulocytosis, high TCD velocity |
| Imaging | TRV >2.5 m/s | |
| Decreased disease severity and mortality | Routine laboratory | Coinheritance of α-thalassemia |
| Molecular | Senegal and Arab-Indian haplotypes |
G6PD, glucose-6-phosphate dehydrogenase; KIM-1, kidney injury molecule 1; NAG, N-acetyl-b-d-glucosaminidase.