Gallbladder Disease in Young Congolese with Sickle Cell Anemia: An Ultrasound Survey

Abstract

Patients with sickle cell anemia have been shown to present with a high prevalence of gallbladder disease. Relatively few data exist on the prevalence of gallbladder disease in Africans with autosomal recessive gene for sickle hemoglobin. To establish this relationship, we examined the 1-year incidence of gallbladder disease among 190 consecutive children and young adults with sickle cell anemia aged 3-24 years using ultrasound. There were 130 males (68.4 per cent) and 60 females (31.6 per cent). Incidence of cholelithiasis, cholecystitis, hydrops of gallbladder, and biliary sludge were 58.4, 25.3, 18.4, and 2.1 per cent, respectively. Of the 190 patients, 61 (37.3 per cent) presented hepatobiliary symptoms. The incidence of cholelithiasis depended on age. The age group 10-14 years and leucocytes > 10000/mm3 were considered as risk factors of the cholelithias onset, while female gender was isolated as a risk factor for the hydrops of the gallbladder outcome. In conclusion, the ultrasonographic examination is recommended for patients with hepatobiliary symptoms with respect to the high prevalence of the autosomal recessive gene for sickle hemoglobin in Congo, Central Africa.

Ultrasonic assessment of the prevalence of gall stones in sickle cell disease children seen at the University of Benin Teaching Hospital, Benin City, Nigeria

“…In Nigeria, the prevalence of gallstones is low in the general population (0.8-1.8%) 22 while that of the Sudanese people is 5.2% 21 . In Congo, a Central Africa country, in a study of 190 young SCD individuals aged 3-24yrs, 58.4% were found to have gallstones 23 . The prevalence of gallstones in this study was lower than the 13% seen amongst the SCD children in Jamaican aged 5 years to 13 years 24 .…”

Clinical phenotypes and the biological parameters of Congolese patients suffering from sickle cell anemia: A first report from Central Africa

“…From the 1950s, multiple researchers have reported an almost total absence of adults suffering from SCA in the Belgian-Congo. 16,19 Age between ACP and MCP was not statistically significant, however, the difference was statistically significant between ACP and SCP. The probable reason is due to the severity of disease in the SCP group leading to early mortality.…”

“…In this cohort, overall mean age was 24.62±12.34 years. From the 1950s, multiple researchers have reported an almost total absence of adults suffering from SCA in the Belgian‐Congo . Age between ACP and MCP was not statistically significant, however, the difference was statistically significant between ACP and SCP.…”

“…This haplotype is considered as a major risk factor associated with the severity of clinical manifestations of the disease . Recent papers show that the lower levels of fetal Hemoglobin (HbF) and F‐cells in Congolese sickle cell patients contribute to this severity . In addition, SCA compromises host immune defense and predisposes to infections from several encapsulated bacteria .…”

“…11,12 Recent papers show that the lower levels of fetal Hemoglobin (HbF) and F-cells in Congolese sickle cell patients contribute to this severity. [13][14][15][16] In addition, SCA compromises host immune defense and predisposes to infections from several encapsulated bacteria. 17 It is known that infection promotes the production of inflammatory proteins, leukocytosis, and Hyperviscosity.…”