Are there clinical phenotypes of homozygous sickle cell disease?

The distribution of clinical features was examined in subjects with homozygous sickle cell (SS) disease in the Jamaican Cohort Study to determine whether there is evidence of distinct clustering of symptoms or clinical phenotypes. A twofold model yielded groups that could be interpreted as painful c...

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Главные авторы: Alexander, N, Higgs, D, Dover, G, Serjeant, G
Формат: Journal article
Язык:English
Опубликовано: 2004
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author Alexander, N
Higgs, D
Dover, G
Serjeant, G
author_facet Alexander, N
Higgs, D
Dover, G
Serjeant, G
author_sort Alexander, N
collection OXFORD
description The distribution of clinical features was examined in subjects with homozygous sickle cell (SS) disease in the Jamaican Cohort Study to determine whether there is evidence of distinct clustering of symptoms or clinical phenotypes. A twofold model yielded groups that could be interpreted as painful crisis or leg ulcer phenotypes and 78% of patients were classified with 95% confidence into one of these. The painful crisis phenotype also manifested higher frequencies of dactylitis, meningitis/septicaemia, acute chest syndrome and stroke. Attempts to define a three-group model were less convincing although 43% of patients could be allocated with 95% confidence. The three-group model essentially divided subjects with the leg ulcer phenotype into subgroups with higher and lower frequencies of painful crisis, dactylitis, meningitis/septicaemia and acute chest syndrome. In the three-group model, the painful crisis phenotype had lower total haemoglobin, fetal haemoglobin, mean cell volume and higher reticulocytes but there was no apparent influence of alpha thalassaemia or beta globin haplotype. Both environmental and genetic factors are likely to contribute to most manifestations of SS disease and the evidence for different clinical phenotypes suggests that a search for associated genetic polymorphisms may provide insights into the mechanisms of clinical variability in SS disease.
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spelling oxford-uuid:427f2fc4-1020-48b7-9606-1bcff98924ce2022-03-26T14:49:50ZAre there clinical phenotypes of homozygous sickle cell disease?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:427f2fc4-1020-48b7-9606-1bcff98924ceEnglishSymplectic Elements at Oxford2004Alexander, NHiggs, DDover, GSerjeant, GThe distribution of clinical features was examined in subjects with homozygous sickle cell (SS) disease in the Jamaican Cohort Study to determine whether there is evidence of distinct clustering of symptoms or clinical phenotypes. A twofold model yielded groups that could be interpreted as painful crisis or leg ulcer phenotypes and 78% of patients were classified with 95% confidence into one of these. The painful crisis phenotype also manifested higher frequencies of dactylitis, meningitis/septicaemia, acute chest syndrome and stroke. Attempts to define a three-group model were less convincing although 43% of patients could be allocated with 95% confidence. The three-group model essentially divided subjects with the leg ulcer phenotype into subgroups with higher and lower frequencies of painful crisis, dactylitis, meningitis/septicaemia and acute chest syndrome. In the three-group model, the painful crisis phenotype had lower total haemoglobin, fetal haemoglobin, mean cell volume and higher reticulocytes but there was no apparent influence of alpha thalassaemia or beta globin haplotype. Both environmental and genetic factors are likely to contribute to most manifestations of SS disease and the evidence for different clinical phenotypes suggests that a search for associated genetic polymorphisms may provide insights into the mechanisms of clinical variability in SS disease.
spellingShingle Alexander, N
Higgs, D
Dover, G
Serjeant, G
Are there clinical phenotypes of homozygous sickle cell disease?
title Are there clinical phenotypes of homozygous sickle cell disease?
title_full Are there clinical phenotypes of homozygous sickle cell disease?
title_fullStr Are there clinical phenotypes of homozygous sickle cell disease?
title_full_unstemmed Are there clinical phenotypes of homozygous sickle cell disease?
title_short Are there clinical phenotypes of homozygous sickle cell disease?
title_sort are there clinical phenotypes of homozygous sickle cell disease
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