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Galiba Atipo Tsiba FO, Mikia CP, Elira Samba JA, Nziengui Mboumba JV, Malanda F, Mikolele Ahoui C, Elira Dokekias A. Associated Factors of Cholelithiasis among Younger Children with Sickle Cell Disease at the National Reference Center for Sickle Cell Disease in Brazzaville, Congo. Anemia 2023; 2023:8887981. [PMID: 37799288 PMCID: PMC10550436 DOI: 10.1155/2023/8887981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/10/2023] [Accepted: 09/07/2023] [Indexed: 10/07/2023] Open
Abstract
Introduction Chronic hemolysis predisposes sickle cell patients to the development of gallstones. Their frequency increases with age, but they may appear early in young children. In the absence of management, they expose the patient to complications that can hinder the quality of life and sometimes even death. This survey aimed to identify the associated factors of the occurrence of cholelithiasis. Materials and Methods It was a case-control study carried out between January 2017 and June 2022 at the National Reference Center for Sickle Cell Disease (SCD) "Antoinette Sassou N'guesso" in Brazzaville. It concerned 37 children with cholelithiasis. Sociodemographic (socioeconomic status and diet) and clinical (body mass index, frequency of vasoocclusive crises and hospitalization for vasoocclusive crises, number of blood transfusion, and chronic complications) as well as hematological examination (type of SCD and blood count in the intercritical period) and hydroxyurea treatment were compared with those of 74 children with no clinical and radiographic signs of cholelithiasis. The chi-squared statistical test and the odds ratio were used for the comparison (p < 0.05). Results The average age was 9.70 ± 1.73 years. The 10-12 age group was the most represented (22 cases or 59.45%), followed by 7- to 9-year-olds (12 cases or 32.43%). Three children (8.10%) were 6 years old. The sex ratio was 0.68 vs. 1.38. Factors associated with cholelithiasis were low socioeconomic status (83.78% vs. 45.95%; IC 95% 1.46-3.89; p ≤ 0.001), a higher number of blood transfusions (5.54 ± 1.22 vs. 2.46 ± 1.13; IC 95% 1.55-6.70; p ≤ 0.001), and irregular systematic monitoring (5.54 ± 1.22 vs. 2.46 ± 1.13; IC 95% 1.55-6.70; p ≤ 0.001). Conclusion A national strategy to facilitate access to care for patients living with sickle cell disease is imperative. Moreover, emphasis should be placed on the prevention and early management of acute complications of SCD.
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Affiliation(s)
- Firmine Olivia Galiba Atipo Tsiba
- National Reference Center for Sickle Cell Disease “Antoinette Sassou Nguesso”, Brazzaville, Congo
- Marien Ngouabi University, Brazzaville, Congo
| | - Clément Pacha Mikia
- National Reference Center for Sickle Cell Disease “Antoinette Sassou Nguesso”, Brazzaville, Congo
| | | | | | - Félix Malanda
- National Reference Center for Sickle Cell Disease “Antoinette Sassou Nguesso”, Brazzaville, Congo
- Marien Ngouabi University, Brazzaville, Congo
| | - Clausina Mikolele Ahoui
- Marien Ngouabi University, Brazzaville, Congo
- Gastroenterology Department, Teaching Hospital of Brazzaville, Brazzaville, Congo
| | - Alexis Elira Dokekias
- National Reference Center for Sickle Cell Disease “Antoinette Sassou Nguesso”, Brazzaville, Congo
- Marien Ngouabi University, Brazzaville, Congo
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Mohamed SOO, Ibrahim OAO, Mohammad DAA, Ali AHM. Correlates of gallbladder stones among patients with sickle cell disease: A meta-analysis. JGH OPEN 2021; 5:997-1003. [PMID: 34584966 PMCID: PMC8454478 DOI: 10.1002/jgh3.12622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 12/16/2022]
Abstract
Sickle cell disorders are the most common hemoglobinopathies worldwide. Clinical variability of sickle cell disease (SCD) and susceptibility to its complications have been attributed to hematologic, genetic, and other influencing factors. This review aimed to provide further summary and analyses of the prevalence and factors associated with cholelithiasis among patients with SCD. A systematic database search was conducted in MEDLINE (PubMed), ScienceDirect, Google Scholar, World Health Organization Virtual Health Library, Cochrane Library databases, and System for Information on Gray Literature in Europe (SIGLE). Pooled prevalence, odds ratio (OR), and standardized mean difference (SMD) with the corresponding 95% confidence interval (CI) were calculated using Comprehensive Meta-Analysis Software version 3.3. A total of 34 studies that fulfilled the eligibility criteria were included in the analyses. The overall prevalence of cholelithiasis among SCD patients was 25.3% (95% CI 19.4-32.3%). The risk of developing cholelithiasis was significantly associated with lower total hemoglobin level (SMD = -0.45; P = 0.002), lower hemoglobin F (HbF) level (SMD = -0.85; P = 0.003), higher total serum bilirubin level (SMD = 1.15; P < 0.001), higher reticulocytes count (SMD = 0.44; P = 0.007), and UDP-glucuronosyltransferase-1A1 enzyme (UGT1A1) promoter polymorphism. This review provides a comprehensive view of the high rate of cholelithiasis and its associated factors in SCD patients.
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Affiliation(s)
- Sagad O O Mohamed
- Department of Paediatrics and Child Health, Faculty of Medicine University of Khartoum Khartoum Sudan
| | - Omer A O Ibrahim
- Department of Internal Medicine University of Khartoum Khartoum Sudan
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Xu ZR, Dan HL, Yu F. Risk factors, manifestations, diagnosis and treatment of cholelithiasis in children. World J Meta-Anal 2021; 9:54-63. [DOI: 10.13105/wjma.v9.i1.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
Cholelithiasis in children refers to cholelithiasis or choledocholithiasis in newborns, infants and adolescents, including a series of symptoms and complications related to stones. The incidence rate of cholelithiasis in children is far lower than that in adults. However, the detection rate of cholelithiasis in children has risen in recent years. The aetiology of cholelithiasis in children is complex, and the pathogenesis is still unclear. According to existing studies, cholelithiasis in children may be related to sex and hormones, obesity, drugs, haemolytic diseases, genetic factors, chemokines, abnormal biliary tract formation, ileal surgery, total parenteral nutrition and other factors. In addition, there is a large occurrence of idiopathic cholelithiasis in children with unknown aetiology. The clinical manifestations of cholelithiasis in children are not completely the same as those in adults, mainly due to the different ages and causes. At present, there is no consensus on the clinical treatment of cholelithiasis in children. Follow-up and observation, drug dissolution and surgical treatment are all treatment methods for children with cholelithiasis. This study reviewed the related literature reports of cholelithiasis in children and summarized the risk factors, clinical manifestations, diagnosis and treatment of cholelithiasis in children to improve the understanding, diagnosis, and treatment of cholelithiasis in children.
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Affiliation(s)
- Zheng-Rong Xu
- Department of Surgery, Hospital of PLA Unit 63820, Mianyang 621000, Sichuan Province, China
| | - Han-Lei Dan
- Department of Surgery, Hospital of PLA Unit 63820, Mianyang 621000, Sichuan Province, China
| | - Fan Yu
- Department of Surgery, Hospital of PLA Unit 63820, Mianyang 621000, Sichuan Province, China
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Olatunya OS, Albuquerque DM, Akanbi GO, Aduayi OS, Taiwo AB, Faboya OA, Kayode TS, Leonardo DP, Adekile A, Costa FF. Uridine diphosphate glucuronosyl transferase 1A (UGT1A1) promoter polymorphism in young patients with sickle cell anaemia: report of the first cohort study from Nigeria. BMC MEDICAL GENETICS 2019; 20:160. [PMID: 31619193 PMCID: PMC6794735 DOI: 10.1186/s12881-019-0899-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/30/2019] [Indexed: 12/22/2022]
Abstract
Background (TA) n repeat sequence (rs8175347) of UGT1A1 gene promoter polymorphism is associated with serum bilirubin levels and gallstones among different sickle cell anaemia (SCA) populations. There are no data on UGT1A1 polymorphisms and their impact on Nigerian SCA patients. In this study, we determined the distribution of the UGT1A1 (TA) n genotypes among a group of young Nigerian SCA patients and healthy controls. In addition, the influence of UGT1A1 (TA) n genotypes on the laboratory and clinical events among the patients was determined. Methods The distribution of the UGT1A1 (TA) n genotypes among 101 young Nigerian SCA patients and 64 normal appropriate controls were determined and studied. The UGT1A1 (TA) n genotypes were further classified into subgroups and used to differentiate the clinical events and laboratory parameters of the patients. Results Four (TA) n alleles:(TA)5, 6, 7, and 8 were found. These were associated with 10 genotypes: TA5/5, 5/6, 5/7, 5/8, 6/6, 6/7, 6/8, 7/7, 7/8, 8/8. The normal (wild-type)-(TA) 6/6), low- (TA) 7/7, 7/8, 8/8), intermediate- (TA) 5/7, 5/8, 6/7, 6/8), and high-activity (TA) 5/5, 5/6,) genotypes were found in 24.8, 24.8, 41.5, and 8.9% patients and 20.3, 15.6, 61, and 3.1% controls respectively. The general genotype distribution of the patients and control group were not significantly different. There were significant differences in serum bilirubin and lactate dehydrogenase (LDH) of the patients when differentiated by the UGT1A1 (TA) n genotypes (p<0.05). Asymptomatic gallstones were found in 5.9% of patients and were significantly of the low-activity genotypes sub-group 5 (20%) vs 1(1.3%) p = 0.0033. Although, bilirubin and fetal hemoglobin (HbF) of patients with gallstones were significantly different from those without gallstone, only the serum bilirubin was associated with UGT1A1 (TA) n genotypes on multivariate analysis (p < 0.0001). Conclusion This study highlights the contribution of UGT1A1 polymorphisms, a non-globin genetic factor, to the laboratory and clinical manifestations of young Nigerian SCA patients for the first time. It also shows that children with co-inheritance of low UGT1A1 (TA) n affinity genotypes may be at risk of gallstone, hence the need to follow them up.
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Affiliation(s)
- Oladele Simeon Olatunya
- Hematology and Hemotherapy Center (Hemocentro), University of Campinas (UNICAMP), Rua Carlos Chagas, 480, Barão Geraldo, Campinas, SP, 13083-970, Brazil. .,Department of Paediatrics, College of Medicine, Ekiti State University, Ado Ekiti, Ekiti State, Nigeria.
| | - Dulcineia Martins Albuquerque
- Hematology and Hemotherapy Center (Hemocentro), University of Campinas (UNICAMP), Rua Carlos Chagas, 480, Barão Geraldo, Campinas, SP, 13083-970, Brazil
| | - Ganiyu Olusola Akanbi
- Department of Radiology, College of Medicine, Ekiti State University, Ado Ekiti, Nigeria
| | | | | | - Opeyemi Ayodeji Faboya
- Department of Medical Biochemistry, College of Medicine, Ekiti State University, Ado Ekiti, Nigeria
| | - Tolorunju Segun Kayode
- Department of Chemical Pathology, Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria
| | - Daniela Pinheiro Leonardo
- Hematology and Hemotherapy Center (Hemocentro), University of Campinas (UNICAMP), Rua Carlos Chagas, 480, Barão Geraldo, Campinas, SP, 13083-970, Brazil
| | - Adekunle Adekile
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Fernando Ferreira Costa
- Hematology and Hemotherapy Center (Hemocentro), University of Campinas (UNICAMP), Rua Carlos Chagas, 480, Barão Geraldo, Campinas, SP, 13083-970, Brazil
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Alhawsawi ZM, Alshenqeti AM, Alqarafi AM, Alhussayen LK, Turkistani WA. Cholelithiasis in patients with paediatric sickle cell anaemia in a Saudi hospital. J Taibah Univ Med Sci 2019; 14:187-192. [PMID: 31435409 PMCID: PMC6695074 DOI: 10.1016/j.jtumed.2019.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 02/23/2019] [Accepted: 02/26/2019] [Indexed: 01/10/2023] Open
Abstract
Objective Sickle cell disease is one of the most common inherited hemoglobinopathies in the world. Chronic haemolysis predisposes individuals to the development of bilirubinate cholelithiasis, which can be asymptomatic or can result in cholecystitis, choledocholithiasis, cholangitis, and gallstone pancreatitis. We aimed to determine the prevalence of cholelithiasis and associated gallstone disease among patients with paediatric sickle cell disease in a Saudi hospital. Methods This retrospective study was conducted among all patients aged between 2 and 18 years. We reviewed the medical records of patients diagnosed with sickle cell anaemia. Mean and standard deviation were calculated for quantitative variables, and the Student t-test was used to compare means. The chi-square test was used to assess those risk factors possibly associated with cholelithiasis. A P-value of ≤0.05 was considered statistically significant. Results Approximately 75% of participants developed cholelithiasis (27.5%) at a mean age of 6.9 ± 3.4 years. The frequency of cholelithiasis was significantly higher with increasing age (40.8% in participants 12 years and older) and among those with high levels of haemoglobin S (Hb S) and mean corpuscular volume (MCV). Moreover, cholelithiasis was more frequent among males than females, Saudis than non-Saudis, and in those with sickle cell disease than in those with sickle thalassemia. However, these differences were not statistically significant. Conclusion In this study, the prevalence of cholelithiasis among children with sickle cell anaemia was found to be high. This association was significantly increased with age and high levels of MCV and Hb S.
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Affiliation(s)
- Zakaria M Alhawsawi
- Pediatric Department, College of Medicine, Taibah University, Almadinah Almunawwarah, KSA
| | | | - Amal M Alqarafi
- College of Medicine, Taibah University, Almadinah Almunawwarah, KSA
| | | | - Waheed A Turkistani
- Maternity and Children Hospital, Ministry of Health, Almadinah Almunawwarah, KSA
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Inah GB, Ekanem EE. Sonographic Diagnosis and Clinical Correlates of Gallbladder Stones in Patients with Sickle Cell Disease in Calabar, Nigeria. Open Access Maced J Med Sci 2019; 7:68-72. [PMID: 30740163 PMCID: PMC6352481 DOI: 10.3889/oamjms.2019.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/19/2018] [Accepted: 10/20/2018] [Indexed: 01/01/2023] Open
Abstract
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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Affiliation(s)
- Grace B. Inah
- Department of Radiology, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Emmanuel E. Ekanem
- Department of Paediatrics, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria
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Wondimu H. Symptomatic Cholilithiasis and Cholecystectomy for a 9-Month-Old Infant: A Case Report. Ethiop J Health Sci 2017; 27:305-308. [PMID: 29217930 PMCID: PMC5615002 DOI: 10.4314/ejhs.v27i3.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 12/21/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Symptomatic cholilithiasis is rare in children. Thus, a high degree of suspicion is required for diagnosis. Once a child is diagnosed with symptomatic cholilithiasis, cholecystectomy is required to relieve the symptoms and prevent complication. CASE DETAILS A 9-month-old infant from Addis Ababa presented to the Pediatric Department of ZewdituMemorial Hospital on January 30, 2015 with irritability, abdominal pain. On workup, she was found to have gall stones, and her condition was at last attributed to biliary colic after months of follow-up in the Department of Pediatrics. She underwent cholecystectomy on the 31st of July 2015 and discharged with improved results. This is the first report of symptomatic cholilithiasis and cholecystectomy in Ethiopia at 9 months of age. CONCLUSION Cholilithiasis is rare in infants, and one should have a high index of suspicion for diagnosis. Cholecystectomy should be done as in adults if symptomatic.
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Affiliation(s)
- Hailu Wondimu
- Department of surgery, school of medicine, college of health sciences, AAU, Addis Ababa, Ethiopia
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