Significant liver disease in sickle cell anaemia and related haemoglobinopathies

ABSTRACT

A prospective study is in progress in order to determine the relationship of viral hepatitis to significant liver disease in patients with sickle cell anaemia and related haemoglobinopathies. Two groups of patients are being studied 1. Patients selected at random from the Sickle Cell Clinic of the University Hospital of the West Indies - These have blood taken for liver function tests and detection of Australia antigen. 2. Patients with sickle cell disease and cholestatic jaundice - these are hospitalized, and have liver biopsies in addition to routine investigations. In none of 106 patients selected from the Sickle cell Clinic, did liver function test reveal evidence of significant liver disease, but three patients had Antigenaemia. The livers of these patients were biopsied, and the appearances on light microscopy were compatible with a form of viral hepatitis in two of them. Two patients have been seen with cholestatic jaundice. One had initial biopsy evidence of acute viral hepatitis without antigenaemia, but showed the picture of chronic persistent hepatitis on follow-up biopsy. The other had initial biopsy evidence of chronic aggressive hepatitis with antigenamia, a repeat biopsy five months later was inadequate for proper histological assessment. These preliminary results suggest that viral hepatitis may play an important role in significant liver disease occasionally seen in patients with sickle cell anaemia and related haemoglobinopathies (AU)