Liver Dysfunction in Thalassemic Children: More in Splenectomized Than Non-Splenectomized Cases

Abstract

Background and Aim: During recent year, liver disease has emerged as a major cause of mortality in patients with β thalassemia major. Multicenter cross-sectional studies have reported that the development and the severity of liver fibrosis are strongly related to the extent of liver iron overload and to the presence of chronic hepatitis infection. This study was conducted to find out the role of iron overload along with concomitant chronic viral infection as a cause of liver dysfunction in patients with β-thalassemia major.Methods: Forty-one β-thalassemia major cases (divided into 2 groups—Group I: 12 splenectomized cases, Group II: 29 non-splenectomized cases) and 20 apparently healthy subjects (Group III) were analyzed at the hour Thalassemic Centre for the assessment of liver dysfunction. Hepatic dysfunction was defined by a ALT level of more than 55 IU/L.Results: Thalassemic cases had significantly higher serum ALT and ferritin level with no significant difference in serum albumin level between cases and controls. ALT value was significantly higher in Group I than Group II. Serum ferritin level was higher in Group I than Group II but it was not statistically significant. There was no significant correlation between ALT and ferritin level. Hepatitis C infection and hepatitis B infection had a prevalence of 24% (10/41) and 2.4% (1/41) respectively among our cases. Out of 10 hepatitis C infection cases, 7 were in Group I and 3 were in Group II. Higher mean ALT value was seen in HCV seropositive cases than HCV seronegative cases.Conclusion: Hepatitis C infection lead to more hepatic dysfunction in splenectomized thalassemic children. More hepatitis C infection cases in splenectomized group could be due to more frequent blood transfusion requirement in these children before splenectomy. However, Liver iron content, fibrosis staging and cirrhosis should be evaluated by liver biopsy in these cases.Conflicts of InterestThe authors have none to declare. Background and Aim: During recent year, liver disease has emerged as a major cause of mortality in patients with β thalassemia major. Multicenter cross-sectional studies have reported that the development and the severity of liver fibrosis are strongly related to the extent of liver iron overload and to the presence of chronic hepatitis infection. This study was conducted to find out the role of iron overload along with concomitant chronic viral infection as a cause of liver dysfunction in patients with β-thalassemia major. Methods: Forty-one β-thalassemia major cases (divided into 2 groups—Group I: 12 splenectomized cases, Group II: 29 non-splenectomized cases) and 20 apparently healthy subjects (Group III) were analyzed at the hour Thalassemic Centre for the assessment of liver dysfunction. Hepatic dysfunction was defined by a ALT level of more than 55 IU/L. Results: Thalassemic cases had significantly higher serum ALT and ferritin level with no significant difference in serum albumin level between cases and controls. ALT value was significantly higher in Group I than Group II. Serum ferritin level was higher in Group I than Group II but it was not statistically significant. There was no significant correlation between ALT and ferritin level. Hepatitis C infection and hepatitis B infection had a prevalence of 24% (10/41) and 2.4% (1/41) respectively among our cases. Out of 10 hepatitis C infection cases, 7 were in Group I and 3 were in Group II. Higher mean ALT value was seen in HCV seropositive cases than HCV seronegative cases. Conclusion: Hepatitis C infection lead to more hepatic dysfunction in splenectomized thalassemic children. More hepatitis C infection cases in splenectomized group could be due to more frequent blood transfusion requirement in these children before splenectomy. However, Liver iron content, fibrosis staging and cirrhosis should be evaluated by liver biopsy in these cases. Conflicts of InterestThe authors have none to declare. The authors have none to declare.