Cholelithiasis in Patients with Sickle Cell Disease and Sickle/Beta-Thalassemia in Akre City, Kurdistan Region of Iraq

Abstract

Background and objectives: Sickle cell disease and sickle β-thalassemia are hemolytic diseases characterized by chronic destruction of the abnormal red cells with consequent hyperbilirubinemia. The present study aimed to determine the association of gallstone with Sickle cell disease and sickle β-thal patients compared to the control healthy group and to determine gallstone's association with several demographic and laboratory parameters among the patients themselves. Methods: Patients visiting the Akre thalassemia center for routine checks have been recruited for this study (patients=73; control=36). Blood samples were collected for biochemical and haematological analyses. All participants were subjected to abdominal ultrasonography for confirmation of gallstones. These parameters were compared with patients' subtype traits. Additional information regarding blood transfusion, hospital admission, and the use of chelating agents was also allocated. Results: The prevalence of gallstone was significantly higher in patients (12%) than in the control (3%) group (P<0.05), with similar prevalence in both trait; homozygous haemoglobin S (14%) and compound heterozygous of hemoglobin S and β-thalassemia (11%), together with significant differences in the biochemical and haematological parameters. The haemoglobin concentration was significantly (P<0.05) reduced in patients (8.5±0.86) versus control (12±1.6). Reticulocytes, lactate dehydrogenase enzyme, and bilirubin were significantly (P<0.05) elevated in patients compared to the control. No differences existed between control versus patients regarding hospital admission, blood transfusion, and the use of medication including chelating agent or hydroxyurea. Conclusion: Sickle-diseased and sickle beta-thalassemia patients have a higher risk of developing gallstones than the general population alongside interruption of metabolic and biochemical parameters with co-association with sub-traits of type of haemoglobin.