Sonographic Diagnosis and Clinical Correlates of Gallbladder Stones in Patients with Sickle Cell Disease in Calabar, Nigeria
DOI:
https://doi.org/10.3889/oamjms.2019.015Keywords:
Sickle cell disease, cholelithiasis, ultrasonographyAbstract
BACKGROUND: Sickle Cell Disease (SCD) causes chronic haemolysis which is a risk factor for cholelithiasis.
AIM: To determine the prevalence and clinical correlates of cholelithiasis in SCD patients in steady state treated at the University of Calabar Teaching Hospital.
METHODS: This was a prospective study that took place at the Haematology and sickle cell disease clinics, University of Calabar Teaching Hospital, Calabar, Nigeria between January and June 2018. The study population were aged between 1.5-5.5 years and confirmed to have SCD through haemoglobin electrophoresis. A brief history was obtained, and all the patients had a physical examination. Ultrasound examination was performed using a B-mode mind-ray ultrasound machine using a 3.5-5.0 MHz probe after an overnight fast. A Calculus is diagnosed when a highly echogenic structure casting a concrete shadow is detected in the lumen of the gallbladder.
RESULTS: One hundred and twenty confirmed SCD patients aged between 1.5-55 years were recruited in the study, 69 (57.5%) were males, while 51 (42.5%) were females. The overall prevalence of cholelithiasis was 10%, and it increased with age. The youngest patient with cholelithiasis was 13 years old. All the patients were asymptomatic at the time of examination. At the multivariate level, age, gender, weight and gallbladder volume were associated with gallbladder stones.
CONCLUSION: The prevalence of cholelithiasis in patients treated at the Sickle Cell Clinic at the University of Calabar Teaching Hospital, Calabar is fairly high. The patients were largely asymptomatic, and cholelithiasis is more common in females than males. This study showed a weak association between blood transfusion and gallbladder stone. It is recommended that routine abdominal ultrasound scan for gallbladder be done for SCD patients from the second decade of life in our environment.
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Stroker DJ, Saifuddin A. Myeloproliferative and similar Disorders. In: Adam A, Dixon AK, editors. Grainger and Allison's Diagnostic Radiology; A Textbook of Medical Imaging. 5th edition Elsevier Limited 2008: 3006-9.
Johnny UM, Bohrer SP. The hemoglobinopathies. In Palmer ES, Reeder MM. Imaging of tropical diseases. 2nd ed. Berlin: Springer-Verlag. 2001; 429-68.
Murphy MF. Diseases of the blood. In: Kumar P, eds. A textbook for medical students and doctors. 3rd ad. London: Bailliere Tindall/ELBS. 1995; 313-18.
Steinberg MH. Sickle cell anaemia, the first molecular disease: Overview of molecular etiology, pathophysiology and therapeutic approaches. Scientific World journal. 2008; 248-324. DOI: https://doi.org/10.1100/tsw.2008.157
Uzoegwu PN, Onwurah AE. Prevalence 0f haemoglobinopathy and malaria diseases in the population of old Aguta Division, Anambra State, Nigeria. Biokemistri. 2003; 15(2):57-66.
Robbins SL, Ranzi E, Vinay K. sickle cell disease. In Robbins Pathologic basis of disease, 6th ed. Philadelphia: W.B. Saunders. 2002; 611-615.
Bookchin RM, Lew VL. Pathophysiology of sickle cell anaemia. Hematol Oncol Clin North Am. 1996; 10:1241-1253. https://doi.org/10.1016/S0889-8588(05)70397-X DOI: https://doi.org/10.1016/S0889-8588(05)70397-X
Lane PA. sickle cell disease. PediatrClin North Am. 1996; 43:638-42. https://doi.org/10.1016/S0031-3955(05)70426-0 DOI: https://doi.org/10.1016/S0031-3955(05)70426-0
Attalla BA, Karrar ZA, Ibnouf G, Mohamed AO, Abdelwahab O, Nasir EM, Seed MA. Outcome of cholelithiasis in Sudanese children with Sickle Cell Anaemia (SCA) after 13 years follow-up. African health sciences. 2013; 13(1):154-9. https://doi.org/10.4314/ahs.v13i1.21 DOI: https://doi.org/10.4314/ahs.v13i1.21
Diagne I, Badiane M, Moreira C, Signate-Sy H, Ndiaye O, Lopez-Sall P, Preira-Sylla G, Camara B, Diouf S, Diack-Mbaye A, Fall M. Lithiase biliaire et drépanocytose homozygote en pédiatrie à Dakar (Sénégal). Archives de pédiatrie. 1999; 6(12):1286-92. https://doi.org/10.1016/S0929-693X(00)88890-9 DOI: https://doi.org/10.1016/S0929-693X(00)88890-9
Parez N, Quinet B, Batut S, Grimprel E, Larroquet M, Audry G, Bégué P. Lithiase biliaire chez l'enfant drepanocytaire: experience d'un hopital pediatrique parisien. Archives de pédiatrie. 2001; 8(10):1045-9. https://doi.org/10.1016/S0929-693X(01)00581-4 DOI: https://doi.org/10.1016/S0929-693X(01)00581-4
Akinyanju O, Ladapo F. Cholelithiasis and biliary tract disease in sickle-cell disease in Nigerians. Postgraduate medical journal. 1979; 55(644):400-2. https://doi.org/10.1136/pgmj.55.644.400 PMid:482184 PMCid:PMC2425577 DOI: https://doi.org/10.1136/pgmj.55.644.400
Gumiero AP, Bellomo-Brandão MA, Costa-Pinto EA. Gallstones in children with sickle cell disease followed up at a Brazilian hematology center. Arquivos de gastroenterologia. 2008; 45(4):313-8. https://doi.org/10.1590/S0004-28032008000400010 PMid:19148360 DOI: https://doi.org/10.1590/S0004-28032008000400010
Nzeh DA, Adedoyin MA. Sonographic pattern of gallbladder disease in children with sickle cell anaemia. Pediatric radiology. 1989; 19(5):290-2. https://doi.org/10.1007/BF02467294 DOI: https://doi.org/10.1007/BF02467294
Serjeant GR, Serjeant BE. Management of sickle cell disease; lessons from the Jamaican Cohort Study. Blood reviews. 1993; 7(3):137-45. https://doi.org/10.1016/0268-960X(93)90001-K DOI: https://doi.org/10.1016/0268-960X(93)90001-K
Agholor CA, Akhigbe AO, Atalabi OM. The prevalence of cholelithiasis in Nigerians with sickle cell disease as diagnosed by ultrasound. British Journal of Medicine and Medical Research. 2014; 4(15):2866. https://doi.org/10.9734/BJMMR/2014/8645 DOI: https://doi.org/10.9734/BJMMR/2014/8645
Carovac, A. Smaj Iovic E, Junuzovic D. Application of ultrasound in medicine, Acta inform med. 2001; 19:168-171. https://doi.org/10.5455/aim.2011.19.168-171 PMid:23408755 PMCid:PMC3564184 DOI: https://doi.org/10.5455/aim.2011.19.168-171
Wickbom IG, Rentzhog U. The reliability of cholecystography. Acta Radiol Daign Stockh. 1995; 44:185-200. https://doi.org/10.3109/00016925509170795 DOI: https://doi.org/10.3109/00016925509170795
Krook PM, Allen PH, Bush WH, Maimer G, McLean MD. Comparison of real time cholecystosonography and oral cholecystography. Arch Surg. 1980; 115:1096-98. https://doi.org/10.1148/radiology.135.1.7360953
Lau SWL. Diagnosis of cholelithiasis: Comparison between Oral Cholecystography and Ultrasonography. Radiology. 1980; 135:145-148. DOI: https://doi.org/10.1148/radiology.135.1.7360953
Shea JA, Berlin JA, Escarce JJ, Clarke JR, Kinosian BP, Cabana MD, Tsai WW, Horangia N Malet PF, Schwartz JS et al. Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. Arch Intern Med. 1994; 15(22):2573-81. https://doi.org/10.1001/archinte.1994.00420220069008 DOI: https://doi.org/10.1001/archinte.1994.00420220069008
Attalla BI. Abdominal sonographic findings in Sudanese children with sickle cell anaemia. Journal of diagnostic Medical Sonography. 2010; 26:276-280. https://doi.org/10.1177/8756479310386788 DOI: https://doi.org/10.1177/8756479310386788
Webb DKH, Darby JS, Tercy S, Serjeant GR. Gallstones in Jamaican children with homozygous sickle cell disease. Arch Dis Child. 1959; 64:693-98. https://doi.org/10.1136/adc.64.5.693 DOI: https://doi.org/10.1136/adc.64.5.693
Bond LR, Hatty SR, Horn ME, Dick M, Meire HB, Bellingham AJ. Gall stones in sickle cell disease in the United Kingdom. Br Med J (Clin Res Ed). 1987; 295(6592):234-6. https://doi.org/10.1136/bmj.295.6592.234 DOI: https://doi.org/10.1136/bmj.295.6592.234
Durosimi MA, Ogunseyinde AO, Olatunji PO, Esan GJ. Prevalence of cholelithiasis in Nigerians with sickle cell disease. Afr J Med Sci. 1989; 18(3):223-7.
Akamaguna AI, Odita JC, Ugbodaga CI, Okafor LA. Cholelithiasis in sickle cell disease: A cholecystographic and ultrasonographic evaluation in Nigerians. Eur J Radiol. 1985; 5:271-72. PMid:3910431
Walker TM, Hambleton IR, Serjeant GR. Gallstones in sickle cell disease: observations from The Jamaican Cohort study. The Journal of pediatrics. 2000; 136(1):80-5. https://doi.org/10.1016/S0022-3476(00)90054-4 DOI: https://doi.org/10.1016/S0022-3476(00)90054-4
Sarnik S, Slovis TL, Corbett DP, Enami E, Whitten CF: Incidence of cholelithiasis in sickle cell anaemia using ultrasonic gray-scale technique. J paediatric 1980; 96: 1005-8. https://doi.org/10.1016/S0022-3476(80)80626-3 DOI: https://doi.org/10.1016/S0022-3476(80)80626-3
Odunvbun ME, Adeyekun AA.Ultrasound assessment of the prevalence of gall stones in sickle cell disease children seen at the University of Benin Teaching Hospital, Benin City, Nigeria. Niger J Paed 2014; (4): 370 – 374. https://doi.org/10.4314/njp.v41i4.16 DOI: https://doi.org/10.4314/njp.v41i4.16
Barrett-Conner E. Cholelithiasis in sickle cell anaemia. Am J Med. 1968; 45:889-898. [PubMed]. https://doi.org/10.1016/0002-9343(68)90187-3 DOI: https://doi.org/10.1016/0002-9343(68)90187-3
Lachman BS, Lazerson J, Starshak RJ, Vaughters FM, Werlin SL. The prevalence of cholelithiasis as diagnosed by ultrasound and cholecystography. Paediatrics. 1979; 64:601-603. DOI: https://doi.org/10.1542/peds.64.5.601
Cameron JL, Mddreg WC, Zuidema GD. Biliary tract disease in sickle cell anaemia: Surgical consideration. Ann Surg. 1971; 174(4):762-710. https://doi.org/10.1097/00000658-197110000-00013 DOI: https://doi.org/10.1097/00000658-197110000-00013
Karayalcin G, Hassani N, Abrams M, Lonzkowsky P. Cholelithiasis in children with sickle cell disease. Am J Dis Child. 1979; 133:306-307. https://doi.org/10.1001/archpedi.1979.02130030082015 DOI: https://doi.org/10.1001/archpedi.1979.02130030082015
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