Liver Enzymes in Children with beta-Thalassemia Major: Correlation with Iron Overload and Viral Hepatitis.
BACKGROUND
Beta Thalassemia is the most common chronic hemolytic anemia in Egypt (85.1%) with an estimated carrier rate of 9-10.2%. Injury to the liver, whether acute or chronic, eventually results in an increase in serum concentrations of Alanine transaminase (ALT) and Aspartate transaminase (AST).


OBJECTIVE
Evaluating the potentiating effect of iron overload & viral hepatitis infection on the liver enzymes.


METHODS
Eighty (80) thalassemia major patients were studied with respect to liver enzymes, ferritin, transferrin saturation, HBsAg, anti-HCV antibody and HCV-PCR for anti-HCV positive patients.


RESULTS
Fifty % of the patients were anti-HCV positive and 55% of them were HCV-PCR positive. Patients with elevated ALT and AST levels had significantly higher mean serum ferritin than those with normal levels. Anti-HCV positive patients had higher mean serum ferritin, serum ALT, AST and GGT levels and higher age and duration of blood transfusion than the negative group. HCV-PCR positive patients had higher mean serum ferritin and serum ALT and also higher age and duration of blood transfusion than the negative group.


CONCLUSIONS
Iron overload is a main leading cause of elevated liver enzymes, and presence of HCV infection is significantly related to the increased iron overload.
Faculty of Medicine, Cairo University, Cairo, Egypt.
Khaled M
KM
Salama
National Research Center, Child Health Department, El Buhouth st., Dokki, Cairo 12311, Egypt.
Ola M
OM
Ibrahim
Faculty of Medicine, Cairo University, Cairo, Egypt.
Ahmed M
AM
Kaddah
National Research Center, Child Health Department, El Buhouth st., Dokki, Cairo 12311, Egypt.
Samia
S
Boseila
National Research Center, Child Health Department, El Buhouth st., Dokki, Cairo 12311, Egypt.
Leila Abu
LA
Ismail
National Research Center, Child Health Department, El Buhouth st., Dokki, Cairo 12311, Egypt.
May M Abdel
MM
Hamid
Beta thalassemia; egyptian children; iron overload; liver enzymes; viral hepatitis