Redefining the Reference Interval and Cut-Off Values of the Hematological and Biochemical Parameters and Deriving a Sensitive Predictive Marker for Crisis Events in Sickle Cell Disease.

The heterogeneity in clinical presentations in sickle cell disease (SCD) alters between crisis and steady state phases. Considering the pathophysiology, it is crucial to establish a disease-specific reference interval for hematological and biochemical parameters and identify the sensitive predictive markers for crisis. The case-control study included fifty-four healthy control, forty SCD cases in crisis state, and forty-six steady state cases. Blood samples were evaluated for complete blood count (CBC) and biochemical parameters. Red cell indices were calculated. 2.5th and 97.5th percentile values were delineated in the steady state cases as new reference interval. The new cut-off values were evaluated for sensitivity and specificity. The steady state cases reported a significant decrease in urea, sodium, Hb, Hct, and RBC count compared to the control group, whereas potassium, and red cell indices were higher. Compared to the steady state, the crisis state depicted a significant increase in urea, liver enzymes, leucocytes, inflammatory indices, and all red cell indices, whereas sodium, albumin, iron, Hb, Hct, and LMR were decreased. The revised 95 percentile ranges were sodium-132.35-143.65 mmol/L, potassium-3.75-6.09 mmol/L, albumin-2.9-5.0 g/dL, Hb-7.51-12.17 g/dL, RBC count-2.2-5.49 × 10 Supplementary Information: The online version contains supplementary material available at 10.1007/s12291-023-01158-9.