Chronic Liver Disease among Adult Patients with Sickle Cell Anemia in Steady State in Ile-Ife, Nigeria

Abstract

Aim: Chronic liver disease encompasses a range of hepatic pathology arising from a wide variety of insults to the liver which can occur in patients with sickle cell anemia. This study is aimed to investigate the prevalence of chronic liver disease among adult patients with sickle cell anemia in steady state attending the hematology clinic of a federal tertiary health institution in Ile-Ife, Nigeria.

Materials and Methods: Basic demographic data, liver ultrasound scan as well as liver function test and Child-Turcotte-Pugh class of 50 consecutive sickle cell anemia (HbSS) patients were compared with those of 50 age- and sex-matched subjects with HbAA as controls.

Results: Each of the study groups (patients and controls) comprised of 21(42%) males and 29(58%) females. The age range of the patients was 18-45years with a mean(±SD) of 27.6±7.607 while that of the controls was 21-43years with a mean(±SD) of 28.0±5.079(p=0.746). Amongst the patients, 32(64%) had hepatomegaly while 18(36%) had normal liver ultrasound findings. In the control group, 1(2%) had fatty liver but none had hepatomegaly. Forty-nine(98%) of the controls had normal liver ultrasound findings. There was a statistically significant difference in the prevalence of hepatomegaly between the patients and controls with p value<0.001. Twenty-four(48 %) of the patients were in CTP class A; 7(29.2%) males and 17(70.8%) females, while the remaining 26(52%) patients were in CTP class B; 14(53.8%) males and 12(46.2%) females. None of the patients was in CTP class C.

Conclusion: In this study, hepatomegaly was a common ultrasound finding in patients with sickle cell anemia. It is essential to assess for evidence of liver disease in patients with sickle cell anemia even when they are not yet symptomatic.