ESPE Abstracts

Background: Growth retardation as well as metabolic and endocrine derangements are of utmost importance among the sickle cell disease (SCD) population.

Objective: To determine the growth pattern in a cohort of Egyptian children with SCD and to determine the impact of endocrine complications and nutritional status on their growth pattern.

Subjects and Methods: This study was a prospective analytical study including 50 SCD children aged from 3 to 10 years, recruited from the Pediatric Hematology Outpatient Clinic, Cairo University. Demographic, clinical, and laboratory parameters were retrieved from medical records. Anthropometric measurements were obtained initially at the start of study then at 3, 6 and 9 months. Thyroid profile was measured by Electrochemiluminescence immunoassay. Nutritional assessment was obtained using 24-h dietary recall and calculating the average caloric daily intake for each child.

Results: The study group consisted of 54% males and 46% females, their mean age at enrollment was 6.92 (± 2.29) years and their mean age at diagnosis was 20.36 (± 19.9) months. At enrollment, only 3 (6%) of our study population were underweight, 9 (18%) were stunted, and only 1 (2%) patient was overweight. However, assessment at 9 months revealed that 8 (16%) were underweight, and 10 (20%) were stunted. Thirty-three (66%) of our study population had poor growth velocity. All patients had normal thyroid profile apart from one patient who had subclinical hypothyroidism. Regarding the average caloric intake among our study population; 43 (86%) had low caloric intake for their age, only 10% were within normal, and 2 (4%) had high caloric intake. SCD patients with poor growth velocity were older in age and were on a higher dose of hydroxyurea (HU) (p-value = 0.022 and 0.013 respectively). There was a significant negative correlation between weight and height assessments initially, at 9 months and the frequency of severe Vaso-occlusive crisis (VOC) [(r = - 0.279, P = 0.05), (r = - 0.310, P = 0.028), (r = - 0.310, P = 0.029), and (r = - 0.307, P = 0.03) respectively]

Conclusion: Sickle cell disease is associated with poor growth velocity (more in older children). Two thirds of our patients had poor growth velocity despite adequate intake of macronutrients reflecting that SCD patients require optimal nutritional requirements for different age groups to meet their higher energy and protein requirements. No reported thyroid abnormalities in SCD patients, however, follow up is recommended.