Sickle Cell Anaemia (SCA) related priapism in Kano, North- Western, Nigeria; re-emphasizing the important role of haemolysis

Background: Priapism is a common albeit under reported complication of Sickle Cell Anaemia (SCA) despite the pain, psychological stress and attendant risk of erectile dysfunction. Some changes in both clinical and laboratory parameters have been associated with priapism in SCA. Aim:This study seeks to determine the clinical and laboratory characteristics of patients with SCA related priapism. Method: A total of 102 adult male patients with SCA were recruited at steady state into this cross-sectional study. Clinical data was extracted using interviewer administered questionnaire and clients’ folders while FBC, haemolytic and biochemical markers were determined for each participant. Data was analysed using SPSS version 21.0 and p < 0.05 was considered significant. Results: The prevalence of priapism was 36.3%. There was no significance difference between SCA patients with and without priapism in terms of age (p = 0.11), age at diagnosis (p = 0.81), marital status (χ2 = 2.06, df = 4, p = 0.09), painful crisis (χ2 = 0.95, df = 4, p = 0.41) and history of hospital admission (χ2 = 0.28, df = 4, p = 0.59). However, SCA patients with priapism had more blood transfusions (χ2 = 46.70, df = 4, p = 0.01), lower haemoglobin (p = 0.01), higher reticulocyte count (p = <0.001) and serum LDH (p = <0.001) compared to SCA patients without priapism. History of blood transfusion (OR = 3.4, 95% CI = 1.6 – 6.5, p = 0.03), higher reticulocyte count (OR = 8.9, 95% CI = 2.4 - 14.8, p = 0.01) and serum LDH (OR = 13.6, 95% CI = 7.6 – 24.3, p = 0.01) were positive predictors of priapism among adults with SCA. Conclusion: Priapism is a high among patients with SCA and haemolytic markers can serve as important determinants of SCA related priapism. There is need for increase awareness of this complication and researches to exploit mechanistic pathways of priapism in SCA.