Assessment of liver function in sickle cell disease

Abstract

Background: The liver is one of the organs involved in the multi-organ failure that occurs in sickle cell disease, the pathophysiology of liver disease in this condition is complex because of the interrelated multifactorial causes.

Aim: The study was aimed at assessing the liver functions in steady state sickle cell disease patients.

Methods: Liver functions were assessed in 60 patients with sickle cell disease in the steady state and 50 control subjects. The transaminases, alkaline phosphatase and bilirubin were done by manual methods using semi auto analyzer for concentration readings.

Results: The mean values of Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP) and Bilirubin (BIL) were 39.10±2.73, 28.53±2.77, 94.12±5.86U/I and 27.99±5.21μmol/l respectively. The corresponding values in controls were 20.66±1.01, 25.16±1.42, 68.00±2.89U/I and 2.55±0.27μmol/l. The AST, ALP and BIL values obtained in sickle cell disease patients were statistically significant when compared with controls while ALT values were not. Age and gender of the patients did not significantly affect the levels of these parameters with the exception of ALP which was significantly higher in the lower age groups.

Conclusion: Increased serum liver function tests except ALT which is not gender and age related were observed in sickle cell disease patients in the steady state and reflect the classic histologic features of Kupffer cell erythrophagocytosis and engorgement of sinusoids by aggregate of sickled red cells.

Key words: Liver enzymes; Transaminases; Sickle cell disease; Bilirubin