Prevalence of cholelithiasis and complications in patients with sickle cell anemia and beta-thalassemia in Saudi Arabian population

Abstract

Background: Saudi Arabia falls in the highly prevalent zone of sickle cell anemia (SCA) and thalassemia. This chronic hemolysis causes the development of bilirubin cholelithiasis, which can be symptomatic, resulting in cholecystitis, choledocholithiasis, ascending cholangitis, or gallstone pancreatitis. The study aims to determine the prevalence of cholelithiasis and associated gallstone complications among patients with sickle cell disease and thalassemia presenting to King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Methods: This retrospective study included patients diagnosed with SCA and thalassemia who had at least an abdominal ultrasound, Computed Tomography, or Magnetic Resonance Imaging. Social, epidemiological, and clinical characteristics, such as gender, age, nationality, Body Mass Index, medical and surgical history, and the presence of other hemoglobinopathies, were collected. In addition, the prevalence of gallstones was assessed and compared between both groups. The association with patients' characteristics was also evaluated. Results: Among the total of 542 patients included, 338 (62.3%) had SCA, of which 184 (54.4%) developed gallstones. Further more 204 (37.5%) had thalassemia, of which 51 (25%) developed gallstones. SCA cases had a higher prevalence of gallstones, sludge, cholecystitis, cholangitis, choledocholithiasis, pancreatitis, and cholecystectomy. The age of gallstone diagnosis is significantly lower in SCA compared with beta-thalassemia (18 ± 9.7 and 25.7 ± 14.2 years, respectively) (p < 0.001). Conclusion: Gallstone disease was more prevalent and diagnosed at a younger age in SCA than in thalassemia patients. However, the incidence of complications and cholecystectomy was similar between the two groups.