Gallstones in children with sickle cell disease followed up at a Brazilian hematology center

Gumiero, Ana Paula dos Santos; Bellomo-Brandão, Maria Ângela; Costa-Pinto, Elizete Aparecida Lomazi da

doi:10.1590/s0004-28032008000400010

Cited by 53 publications

(46 citation statements)

References 10 publications

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“…This number is due to the greater risk of these individuals developing gallstones, which is in accordance with what has been previously reported in the literature, estimated at 50% 16, 17. Splenectomy was another procedure commonly performed in the patients of the current study (14%).…”

Section: Discussionsupporting

confidence: 91%

Clinical and laboratory profile of patients with sickle cell anemia

Sant’Ana

Araujo

Pimenta

et al. 2017

Revista Brasileira de Hematologia e Hemoterapia

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ObjectiveThis study aimed to describe and analyze clinical and laboratory characteristics of patients with sickle cell anemia treated at the Hemominas Foundation, in Divinópolis, Brazil. Furthermore, this study aimed to compare the clinical and laboratory outcomes of the group of patients treated with hydroxyurea with those patients that were not treated with hydroxyurea.MethodsClinical and laboratorial data were obtained by analyzing medical records of patients with sickle cell anemia.ResultsData from the medical records of 50 patients were analyzed. Most of the patients were female (56%), aged between 20 and 29 years old. Infections, transfusions, cholecystectomy, splenectomy and systemic arterial hypertension were the most common clinical adverse events of the patients. The most frequent cause of hospitalization was painful crisis. The majority of patients had reduced values of hemoglobin and hematocrit (8.55 ± 1.33 g/dL and 25.7 ± 4.4%, respectively) and increased fetal hemoglobin levels (12 ± 7%). None of the clinical variables was statistically significant on comparing the two groups of patients. Among hematological variables only hemoglobin and hematocrit levels were statistically different between patients treated with hydroxyurea and untreated patients (p-value = 0.005 and p-value = 0.001, respectively).ConclusionSickle cell anemia requires treatment and follow-up by a multiprofessional team. A current therapeutic option is hydroxyurea. This drug reduces complications and improves laboratorial parameters of patients. In this study, the use of the drug increased the hemoglobin and hematocrit levels of patients.

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Section: Discussionsupporting

confidence: 91%

Clinical and laboratory profile of patients with sickle cell anemia

Sant’Ana

Araujo

Pimenta

et al. 2017

Revista Brasileira de Hematologia e Hemoterapia

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“…Patients with SCD reporting episodic abdominal pain should be investigated for cholelithiasis, which is present in 50% by 18 years of age. [13][14][15] Abdominal ultrasound can usually diagnose cholelithiasis in patients with SCD, with nuclear hepatobiliary scans rarely being necessary. Children with symptomatic cholelithiasis should have scheduled cholecystectomy, both to prevent further pain episodes and to eliminate the risk for acute cholecystitis or associated pancreatitis.…”

Section: Cholelithiasismentioning

confidence: 99%

Abdominal Pain in Children With Sickle Cell Disease

Rhodes

Bates

Andrews

et al. 2014

Journal of Clinical Gastroenterology

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The differential diagnosis of abdominal pain is broad in any child, and further complicated in children with sickle cell disease (SCD). Acute causes of abdominal pain may require emergent surgery, such as for appendicitis or obstruction caused by a bezoar. Rapid intervention is necessary and life-saving in children with SCD and acute splenic or hepatic sequestration. The majority of children with SCD presenting to the physician's office or emergency department will have subacute reasons for their abdominal pain, including but not limited to constipation, urinary tract infection, peptic ulcer disease, and cholecystitis. Vaso-occlusive pain often presents in children as abdominal pain, but is a diagnosis of exclusion. The case of a 10-year-old girl with intermittent abdominal pain is used as a starting point to review the pathophysiology, diagnosis, and treatment of the most acute and common causes of abdominal pain in children with SCD.

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“…If excessive bilirubin excretion related to chronic hemolysis is a major risk factor for gallstones formation, other conducive factors which have not been identified yet could intervene [1] [4]. Many studies show that the prevalence of cholelithiasis in patients with sickle cell disease increases with age and affects 6% of patients before 15 years of age and more than 50% of young adults [1] [5] [6]. Gallstones treatment is equivocal but most of studies recommend cholecystectomy in the symptomatic cases and regular ultrasonography in the other cases [3] [7].…”

Section: Introductionmentioning

confidence: 99%

Cholelithiasis in Children with Sickle Cell Disease in Ouagadougou Pediatric Hospital

Kouéta¹,

Kaboret²,

Yonaba³

et al. 2015

OJPed

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Introduction: Sickle cell disease (SCD) causes chronic hemolysis which is a risk factor for cholelithiasis. Its development may lead to severe and life-threatening complications. Objective: Determine the prevalence of cholelithiasis, the conditions of diagnosis and related factors. Materials and Method: We retrospectively reviewed records of 110 patients with sickle cell disease followed up in Charles de Gaulle University Pediatric Hospital from January 2003 to December 2013, including 103 patients who had abdominal ultrasonography. Results: Cholelithiasis prevalence was 24.3%. The mean age of patients was 10.8 years, (range 3 to 15 years). Sex ratio was 2.1. In 88% cases, cholelithiasis was diagnosed based on the characteristic symptoms of right hypocondrial pain, fever and icterus. Most factors associated with cholelithiasis were as follows: age above 10 years (OR = 4), occurrence of at least three (03) vaso-occlusive crises per year (OR = 7.6), history of blood transfusion (OR = 8), right hypochondrial pain (OR = 4.5) and icterus (OR = 15). Only 20% of patients suffering from a symptomatic cholelithiasis underwent laparoscopic cholecystectomy and results were conclusive. Conclusion: Patients with sickle cell disease, especially those aged above 10, should be routinely tested for cholelithiasis using abdominal ultrasonography at least once a year. Because of the difficulties in managing evolutive complications in case of an emergency in our context, we advocate laparoscopic cholecystectomy of any cholelithiasisas soon as it is diagnosed in children with sickle cell disease.

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Gallstones in children with sickle cell disease followed up at a Brazilian hematology center

Cited by 53 publications

References 10 publications

Clinical and laboratory profile of patients with sickle cell anemia

Clinical and laboratory profile of patients with sickle cell anemia

Abdominal Pain in Children With Sickle Cell Disease

Cholelithiasis in Children with Sickle Cell Disease in Ouagadougou Pediatric Hospital

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