An evaluation of the gallbladder in adult sickle cell anemia patients in Zaria North-West Nigeria

Abstract

Background: Sickle cell anemia (SCA) is characterized by a constant state of hemolysis which leads to hyperbilirubinemia. Hyperbilirubinemia may predispose to development of pigment gallstones in these patients. Gallstones in SCA patients increase morbidity and mortality and poses diagnostic dilemma as most patients are asymptomatic. The objective of this study was to evaluate the gallbladder using ultrasonography, biochemical, and hematological parameters among adult SCA patients in steady state at the Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Patients and Method: We conducted a case-control cross-sectional study of adult SCA patients attending the hematology clinic of ABUTH, Zaria, Nigeria and HbAA controls. Sixty-seven consenting adult SCA patients in steady state and twenty HbAA controls had abdominal ultrasonography, biochemical, and hematological tests on blood samples. Information obtained was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 17.0. Statistical evaluation consisted of descriptive analysis and comparison of means using student's t-test. Level of significance was set at P Results: Of the 67 SCA patients, 19 (28.4%) had gallstones, and the prevalence increased with increasing age of the patients. There were significant differences in all laboratory parameters between SCA patients and the HbAA controls except alkaline phosphatase levels. While there were no significant differences in these parameters between SCA patients with gallstone and those without gallstone except the gallbladder volume. All the SCA patients with gallbladder stones were asymptomatic. Conclusion: There is a high prevalence of gallbladder stone in SCA patients, especially after the age of 20 years. Thus, abdominal ultrasonography should be part of the routine care of SCA patients, especially after the second decade of life.