Table of Contents
ISRN Hematology
Volume 2013, Article ID 236374, 5 pages
http://dx.doi.org/10.1155/2013/236374
Clinical Study

Addition of Multimodal Therapy to Standard Management of Steady State Sickle Cell Disease

1Department of Haematology, University of Nigeria Teaching Hospital, Enugu 46000, Nigeria
2Department of Haematology, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
3Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu 46000, Nigeria

Received 18 July 2013; Accepted 30 September 2013

Academic Editors: W. Fiedler and T. Ikuta

Copyright © 2013 Iheanyi Okpala et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Most people on folic acid to boost erythropoiesis and prophylactic antimicrobials, the standard management of steady state sickle cell disease (SCD), have unacceptable numbers of crises. The objective of this study was to evaluate the effects of adding multimodal therapy with potassium thiocyanate and omega-3 fatty acids to the standard management of steady state SCD. Pre- and post-treatment numbers of crises and other disease indices were compared in 16 HbSS individuals on folic acid and paludrine after 12 months of adding eicosapentaenoic acid 15 mg/kg/day, docosahexaenoic acid 10 mg/kg/day, and potassium thiocyanate 1-2 mL/day, each milliliter of which contained 250 mg of thiocyanate and 100 micrograms of iodine to prevent hypothyroidism: a possible side-effect due to competitive inhibition of the transport of iodide into the thyroid gland by thiocyanate. Median number of crises reduced from 3/yr to 1/yr ( ). There was no evidence of impaired thyroid function. Plasma level of tri-iodothyronine improved ( ). Steady state full blood count and bilirubin level did not change significantly. The findings suggest that addition of potassium thiocyanate and eicosapentaenoic and docosahexaenoic acids to standard management of steady state SCD reduces the number of crises. This observation needs to be evaluated in larger studies.