title: Frequency of cholelithiasis in patients with Beta-thalassemia intermedia with and without hydroxyurea.
abstract: BACKGROUND
  Recent studies regarding the effect of hydroxyurea (HU) in thalassemia have revealed favorable effects on the reduction of ineffective erythropoiesis.
  
  
  OBJECTIVE
  The aim of the current study was to evaluate whether or not HU can have an effect on the gallstone formation rate in patients with beta-thalassemia intermedia (BTI).
  
  
  METHODS
  In this case control cross-sectional study, from a total of 250 transfusion-independent BTI patients, 51 patients who were taking HU, participated in the study. Patients were registered in the Thalassemia clinic of Shiraz University of Medical Sciences, Shiraz, which is a referral center located in southern Iran, during 2011-2012. Mean dose of HU consumption in the case group was 10 ± 2.5 mg/kg/day (range of 8-15 mg/kg/day), with a mean duration of consumption of 7.5 ± 3.8 years (range 1-14 years). In addition, 41 age- and sex-matched BTI patients who did not use HU were randomly selected as a control group. All patients underwent abdominal ultrasound by a radiologist for evaluation of gallstones.
  
  
  RESULTS
  Mean age of the participants was 21.4 ± 6.5 years (10-40 years). There was no statistically significant difference regarding the frequency of cholelithiasis between the two groups of patients (P = 0.822). Our study showed significantly lower hemoglobin levels and a higher percentage of nucleated red blood cells in the HU group compared with the control group (P = 0.001 and P = 0.005, respectively).
  
  
  CONCLUSIONS
  It seems that taking HU for long periods can reduce hemolysis and bone marrow suppression, and that decreases the rate of cholelithiasis. We believe that if these patients had not been treated with HU, we would probably have observed a significantly higher frequency of cholelithiasis, due to more hemolysis compared with patients not taking HU. Further studies with larger sample sizes are suggested.
authors.affiliation: Department of Biology, Faculty of Sciences, Zabol University of Medical Sciences, Zabol, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Khavari
authors.affiliation: Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Azin
authors.initials: A
authors.lastname: Hamidi
authors.affiliation: Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Sezaneh
authors.initials: S
authors.lastname: Haghpanah
authors.affiliation: Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Mohammad Hadi
authors.initials: MH
authors.lastname: Bagheri
authors.affiliation: Department of Library and Information Sciences, College of Humanities, Khouzestan Science and Research Branch, Islamic Azad University, Ahvaz, IR Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Bardestani
authors.affiliation: Ministry of Health and Medical Education, Tehran, IR Iran.
authors.forename: Razieh
authors.initials: R
authors.lastname: Hantooshzadeh
authors.affiliation: Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Karimi
keywords: Beta Thalassemia Intermedia; Cholelithiasis; Hydroxyurea