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Incidence of congenital hemolytic anemias in young cholelithiasis patients
Ali Ezer1, Nurkan Torer, Tarik Zafer Nursal
1Department of General Surgery, University of Baskent, Ankara 06490, Turkey. ezerali@hotmail.com
Insights
Congenital hemolytic anemias (CHA) are found in young patients with gallstones. Lower hemoglobin and MCV levels in patients under 35 with 2-5 gallstones may indicate CHA.
Area of Science:
- Hematology
- Gastroenterology
- Genetics
Background:
- Cholelithiasis (gallstones) can occur in young individuals.
- Congenital hemolytic anemias (CHA) are a group of inherited blood disorders.
- The relationship between CHA and cholelithiasis in young patients is not well-established.
Purpose of the Study:
- To determine the incidence of CHA in patients under 35 years old diagnosed with cholelithiasis.
- To identify potential screening markers for CHA in this patient group.
Main Methods:
- Prospective study of 53 young cholelithiasis patients (<35 years).
- Collection of medical history, family history, and gallstone data.
- Blood tests included complete blood count, Wright-Giemsa staining, reticulocyte count, hemoglobin electrophoresis, lactate dehydrogenase, bilirubin, and lipid profile.
Main Results:
- Twelve patients (22.6%) were diagnosed with thalassemia trait and/or iron-deficiency anemia.
- Significantly lower hemoglobin (P=0.046) and slightly lower mean corpuscular volume (MCV) and hematocrit levels were observed.
- Patients diagnosed with anemia had significantly fewer gallstones (P=0.007).
Conclusions:
- In endemic areas, consider CHA in young cholelithiasis patients (<35 years) with 2-5 gallstones.
- Mean corpuscular volume (MCV) and hemoglobin (Hb) levels can be indicative of CHA in these patients.
Aim:
To clarify the incidence of congenital hemolytic anemias (CHA) in young cholelithiasis patients and to determine a possible screening test based on the results.
Methods:
Young cholelithiasis patients (< 35 years) were invited to our outpatient clinic. Participants were asked for comorbidities and family history. The number of gallstones were recorded. Blood samples were obtained to perform a complete blood count, standard Wright-Giemsa staining, reticulocyte count, hemoglobin (Hb) electrophoresis, serum lactate dehydrogenase and bilirubin levels, and lipid profile.
Results:
Of 3226 cholecystectomy patients, 199 were under 35 years, and 190 with no diagnosis of CHA were invited to take part in the study. Fifty three patients consented to the study. The median age was 29 years (range, 17-35 years), 5 were male and 48 were female. Twelve patients (22.6%) were diagnosed as thalassemia trait and/or ıron-deficiency anemia. Hb levels were significantly lower (P = 0.046), and mean corpuscular volume (MCV) and hematocrit levels were slightly lower (P = 0.072 and 0.082, respectively) than normal. There was also a significantly lower number of gallstones with the diagnosis (P = 0.007).
Conclusion:
In endemic regions, for young cholelithiasis patients (age under 35) with 2-5 gallstones, the clinician/surgeon should pay attention to MCV and Hb levels as indicative of CHA.
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