Prevalence of raised transaminases and associated risk factors in stable sicklers in Lagos, Nigeria

Abstract

Background: Elevation of serum transaminases is common in sickle cell anaemia (SCA)  atients and the causes are multiple and may be due to the underlying sickling state or complications of multiple blood transfusions.
Objectives: To determine the prevalence of raised serum transaminases in stable patients with SCA, and to evaluate the relationship between raised serum transaminase and common risk factors for such elevations in stable patients with SCA.
Methods: One hundred and eighty five stable SCA patients attending the Lagos University Teaching Hospital (LUTH) SCA clinic, and one hundred and eighty three age- and sex- matched healthy controls were studied between May and November 2011. They were administered a questionnaire, and blood samples were collected for the transaminases (Alanine transaminase, ALT and Aspartate transaminase, AST) and for serology for hepatitis B surface antigen and antibodies to hepatitis C virus.
Results: Female: male ratio was 1.3: 1 in the cases and 1.2: 1 in the controls. Mean age of the cases was 26.9± 8.1 years and 26.2 ± 6.9 years for the controls. The serum ALT was elevated in 10.8% of cases and in 6% of the controls (p=0.07). Serum AST was elevated in 88% of the cases and in 53% of the controls (p=0.001). The mean serum ALT values for the cases and the controls were 12.8 ± 8.8 U/L and 8.6 ± 4.8 U/L respectively (p=0.001), while for AST they were 35.2 ± 20.1 U/L and 21.5 ± 10.9 U/L respectively (p=0.001). There was no significant association between elevations in the transaminases and the common risk factors.
Conclusion: Patients with SCA are significantly more likely than controls to have elevation of their serum transaminases levels. They also have significantly higher values than controls. There was no significant association between elevations in the transaminases and the common risk factors.

Keywords: Sickle Cell Anaemia, Transaminase, Risk Factors, Prevalence, Stable.