l-arginine levels are diminished in adult acute vaso-occlusive sickle cell crisis in the emergency department
Bernard L. Lopez, MD, Department of Emergency Medicine, Jefferson Medical College, 1020 Sansom Street, 239 Thompson Building, Philadelphia, PA 19107, USA. E-mail: [email protected]
Abstract
Summary. Paediatric studies have demonstrated that l-arginine (l-arg), the precursor to nitric oxide, is diminished in vaso-occlusive crisis (VOC). This study aimed to determine whether l-arginine levels are altered in adult VOC in the emergency department. Plasma l-arg and nitric oxide metabolite (NOx) levels were obtained in adult VOC patients presenting to the emergency department. Fifty patients had significantly low plasma l-arg (29·78 μmol/l ± 11·21, P < 0·05 vs steady-state control = 41·16 μmol/l ± 5·04) and significantly low plasma NOx (12·33 μmol/l ± 10·28, P < 0·05 vs steady-state control = 25·2 ± 2·6 µmol/l). Neither l-arg nor NOx levels could predict VOC clinical course.
