Cholelithiasis in Chronic Hemolytic Anemias

Abstract

The association of hemolytic diseases with cholelithiasis is so well established that an underlying hemolytic process should be considered when gallstones are observed in young patients. Abnormalities in gallbladder function or bile metabolism may contribute to gallstone formation in these patients. The fact that gallstone disease is frequently asymptomatic tends to underestimate the true frequency and obscure real associations. This study was performed on 60 patients with chronic hemolytic anemia and 50 controls. These patients were subdivided into 35 patients with beta­ thalassemia, 11 patients with sickle cell disease, I 0 patients with hereditary spherocytosis and 4 patients with hereditary persistant fetal hemoglobin (HPFH). These patients were su jected to careful clinical history with special emphasis on frequency and time of blood transfusion, history of jaundice, gallbladder colics and chelation therapy. Thorough clinical examination was done with special emphasis on presence of jaundice, abdominal tenderness, hepatic size and splenic size. Laboratory investigations were done including complete blood picture, hemoglobin electrophoresis, osmotic fragility, liver function tests (serum transaminases, serum bilirubin and serum alkaline phosphatase), HCV antibodies and serum ferritin Abdominal ultrasonography was performed to both patients and controls for detection of cholelithiasis, sludge and other