Liver Enzymes in Children with beta-Thalassemia Major: Correlation with Iron Overload and Viral Hepatitis

Khaled M Salama, Ola M Ibrahim, Ahmed M Kaddah, Samia Boseila, Leila Abu Ismail, May M Abdel Hamid, Khaled M Salama, Ola M Ibrahim, Ahmed M Kaddah, Samia Boseila, Leila Abu Ismail, May M Abdel Hamid

Abstract

Background: Beta Thalassemia is the most common chronic hemolytic anemia in Egypt (85.1%) with an estimated carrier rate of 9-10.2%. Injury to the liver, whether acute or chronic, eventually results in an increase in serum concentrations of Alanine transaminase (ALT) and Aspartate transaminase (AST).

Aim: Evaluating the potentiating effect of iron overload & viral hepatitis infection on the liver enzymes.

Patients and methods: Eighty (80) thalassemia major patients were studied with respect to liver enzymes, ferritin, transferrin saturation, HBsAg, anti-HCV antibody and HCV-PCR for anti-HCV positive patients.

Results: Fifty % of the patients were anti-HCV positive and 55% of them were HCV-PCR positive. Patients with elevated ALT and AST levels had significantly higher mean serum ferritin than those with normal levels. Anti-HCV positive patients had higher mean serum ferritin, serum ALT, AST and GGT levels and higher age and duration of blood transfusion than the negative group. HCV-PCR positive patients had higher mean serum ferritin and serum ALT and also higher age and duration of blood transfusion than the negative group.

Conclusion: Iron overload is a main leading cause of elevated liver enzymes, and presence of HCV infection is significantly related to the increased iron overload.

Keywords: Beta thalassemia; egyptian children; iron overload; liver enzymes; viral hepatitis.

Figures

Figure 1
Figure 1
Percentage of patients with normal and elevated levels of biochemical parameters.
Figure 2
Figure 2
Correlation between serum ferritin and GGT level.

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