Predisposing factors for advanced liver fibrosis in patients with sickle cell disease

Sickle cell disease (SCD) is one of the most common monogenic disorders worldwide and liver complications are common in this group of patients. Our study aims to highlight the prevalence of chronic liver complications and the main predisposing factors for advanced liver fibrosis in SCD patients. For...

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Published in:British journal of haematology 2023-09, Vol.202 (6), p.1192-1198
Main Authors: Manganas, Konstantinos, Delicou, Sophia, Xydaki, Aikaterini, Kourakli, Alexandra, Evliati, Loukia, Vlachaki, Efthymia, Klironomos, Evangelos, Diamantidis, Michail, Lafiatis, Ioannis, Kattamis, Antonios, Koskinas, John
Format: Article
Language:English
Subjects:
Bilirubin
Cholestasis
Cirrhosis
Congestive heart failure
Fibrosis
Hematology
Hepatitis
Liver
Liver diseases
Morbidity
Sickle cell anemia
Sickle cell disease
Thalassemia
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Summary:Sickle cell disease (SCD) is one of the most common monogenic disorders worldwide and liver complications are common in this group of patients. Our study aims to highlight the prevalence of chronic liver complications and the main predisposing factors for advanced liver fibrosis in SCD patients. For this purpose, 219 patients from eight Thalassemia and Sickle Cell Units across Greece enrolled in our study and history of liver related disease complications was recorded, as well as a full laboratory and imaging analysis concerning their liver function. 13.6% of the patients had advanced liver fibrosis. The presence of liver fibrosis was significantly correlated with advanced age, male gender, cholelithiasis and higher LDH, γ-GT, INR, direct and indirect bilirubin levels. These patients had exhibited significantly more episodes of liver crises and acute intrahepatic cholestasis. No correlation was observed with right heart failure or previous viral hepatitis. Patients with advanced liver fibrosis were receiving a more intensive transfusion therapy for a longer period of time and had higher Liver Iron Concentration levels. Our study shows that liver complications and cirrhosis is a significant cause of morbidity in patients with SCD and it is primarily associated with intravascular hemolysis and vaso-occlusive phenomena and secondarily with iron overload.
ISSN:0007-1048
1365-2141
DOI:10.1111/bjh.18970