title: Chronic liver abnormalities in sickle cell disease: a clinicopathological study in 70 living patients.
abstract: OBJECTIVE
  The present study aimed to evaluate the incidence and etiology of chronic liver abnormalities in 70 living patients with sickle cell disease from the Hematology and Hemotherapy Center of the State University of Campinas.
  
  
  METHODS
  Clinical and laboratory investigations, including liver function tests, serological tests for viral hepatitis and abdominal ultrasound, were performed in all patients. Additionally, liver biopsies were taken from 20 patients.
  
  
  RESULTS
  Sixty-seven (96%) patients had some liver abnormality; these included abnormal liver function tests, viral hepatitis, liver ultrasonographic changes or cholelithiasis. The sickling process was the only explanation for the abnormal liver function tests or liver ultrasonographic changes in 24% of these patients. One or more defined reasons, including viral hepatitis, cholelithiasis, clinical hemosiderosis, alcoholism or diabetes, justified the liver abnormalities in 76% of the patients. Nineteen of the 20 liver biopsies presented some degree of vascular lesion; other histological findings were associated with hemosiderosis, viral hepatitis or cholestasis.
  
  
  CONCLUSIONS
  In patients with sickle cell disease, chronic liver abnormalities are frequent and seem to be a multifactorial phenomenon, depending on overlapping factors such as cholelithiasis, viral damage, iron overload and also the primary disease itself.
authors.affiliation: Hematology and Hemotherapy Center, State University of Campinas, Campinas, Brazil.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Traina
authors.forename: Stefano Gonçalves
authors.initials: SG
authors.lastname: Jorge
authors.forename: Ademar
authors.initials: A
authors.lastname: Yamanaka
authors.forename: Luciana R
authors.initials: LR
authors.lastname: de Meirelles
authors.forename: Fernando Ferreira
authors.initials: FF
authors.lastname: Costa
authors.forename: Sara T O
authors.initials: ST
authors.lastname: Saad
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008099:Liver / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography