Background
Thalassemia is the most common hereditary disorder. Worldwide, ∼7% of the population have hemoglobinopathy. In Egypt, it represents a significant public health concern. Liver disease is accelerated by iron overload, which leads to more inflammation and fibrosis, in addition to adverse effects of iron chelating agents. Iron overload is usually unavoidable in beta-thalassemia, particularly with less intensive chelation treatment. The ineffective erythropoiesis causes higher intestinal absorption, which results in chronic iron overload.
Aim
To evaluate the liver status in transfusion-dependent children with thalassemia major at Assiut University Children Hospital.
Patients and methods
A total of 100 patients with thalassemia major on regular blood transfusion were evaluated clinically and through laboratory investigations including liver function, serum ferritin, viral hepatitis markers, hepatomegaly, liver cirrhosis, liver fibrosis, and splenomegaly.
Results
This descriptive cross-sectional study included 100 patients with thalassemia major, and 64% of them received chelation therapy. Overall, 12% of the patients were positive hepatitis C virus (HCV) antibody. There was a strong correlation between serum ferritin and alanine aminotransferase and aspartate aminotransferase. Patients with positive HCV antibody had higher levels of alanine aminotransferase and aspartate aminotransferase. In addition, there are high levels of serum ferritin in patients with HCV-positive antibodies.
Conclusion
Hepatic affection is common in thalassemic patients, which is more profound in patients with iron overload and those with chronic hepatitis C infection. Screening of liver affection using abdominal sonography, liver enzymes, serum ferritin, and virology screening seems to be essential for management of patients with thalassemia major.