L-arginine levels are diminished in adult acute vaso-occlusive sickle cell crisis in the emergency department

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 mumol/l +/- 11.21, P < 0.05 vs steady-state control = 41.16 mumol/l +/- 5.04) and significantly low plasma NOx (12.33 mumol/l +/- 10.28, P < 0.05 vs steady-state control = 25.2 +/- 2.6 mumol/l). Neither l-arg nor NOx levels could predict VOC clinical course.