title: Effects of chronic transfusions on abdominal sonographic abnormalities in children with sickle cell anemia.
abstract: OBJECTIVE
  To assess the effects of chronic erythrocyte transfusions on prevalence of sonographic incidence of organ damage in children with sickle cell anemia (SCA).
  
  
  METHODS
  Children (N=148; mean age, 13.0 years) with SCA, receiving chronic transfusions (average, 7 years), underwent abdominal sonography at 25 institutions. After central imaging review, spleen, liver, and kidney measurements were compared with published normal values. Potential relations between ultrasound, clinical, and laboratory data were explored via analysis of variance, Student t test, and Cochran-Mantel-Haenzel tests of non-zero correlation.
  
  
  RESULTS
  Average spleen length was similar to normal children, but over one-third had spleen volumes >300 mL, 15 had previous splenectomy for splenomegaly, and 24 had abnormal splenic echotexture. Two-thirds had hepatobiliary disease; 37 had prior cholecystectomy, 46 had gallstones, and 16 had gallbladder sludge. Gallbladder disease correlated with older age (P=.002), longer liver length (P<.001), longer duration of transfusions (P=.034), and higher total bilirubin (P<.001). Liver (P<.001) and renal lengths (P≤.005) were larger than published norms.
  
  
  CONCLUSIONS
  In children with SCA, long-term transfusion therapy may not prevent development or progression of abdominal organ dysfunction.
authors: Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, TN 38105, USA. beth.mccarville@stjude.org
authors: Mary Beth
authors: MB
authors: McCarville
authors: Zora R
authors: ZR
authors: Rogers
authors: Sharada
authors: S
authors: Sarnaik
authors: Paul
authors: P
authors: Scott
authors: Banu
authors: B
authors: Aygun
authors: Lee
authors: L
authors: Hilliard
authors: Margaret T
authors: MT
authors: Lee
authors: Karen
authors: K
authors: Kalinyak
authors: William
authors: W
authors: Owen
authors: Julian
authors: J
authors: Garro
authors: William
authors: W
authors: Schultz
authors: Nancy
authors: N
authors: Yovetich
authors: Russell E
authors: RE
authors: Ware
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D017707:Erythrocyte Transfusion / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D013163:Splenomegaly / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D055815:Young Adult