Related Experiment Videos
The significance of gallstones in children with sickle cell anemia
C Alexander-Reindorf1, R U Nwaneri, R G Worrell
1Center for Sickle Cell Disease, Howard University College of Medicine, Washington, DC.
Insights
Gallstones in children with sickle cell anemia may cause infections, leading to more hospitalizations. Treating gallstones could potentially reduce illness in these young patients.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Gastroenterology
Background:
- Infection is a primary cause of severe illness, hospitalization, and death in children with sickle cell anemia.
- Gallstones, particularly pigment stones, are hypothesized to act as a source of infection, increasing morbidity in this vulnerable population.
Purpose of the Study:
- To investigate the hypothesis that gallstones serve as a nidus for infection in pediatric sickle cell anemia patients.
- To explore the association between gallstones and healthcare utilization (hospitalizations, ambulatory visits) in this cohort.
Main Methods:
- Retrospective review of medical records for 86 pediatric sickle cell anemia patients (ages 1-19) at Howard University Center for Sickle Cell Disease.
- Analysis of patient data over 602 patient-years, comparing those with and without gallstones regarding hospitalization and ambulatory visit frequency.
Main Results:
- Patients with sickle cell anemia and gallstones experienced significantly higher healthcare utilization.
- Mean hospitalizations: 10.24 for patients with gallstones vs. 4.26 for those without.
- Mean ambulatory visits: 25.35 for patients with gallstones vs. 13.41 for those without.
Conclusions:
- Gallstones are associated with increased morbidity, evidenced by higher hospitalization and ambulatory visit rates in children with sickle cell anemia.
- Interventions such as cholecystectomy or cholelithotripsy for gallstones may reduce infection-related morbidity in these patients.
Abstract:
Infection is the most common cause of high morbidity, hospitalization, and mortality in children with sickle cell anemia. In this study of pediatric sickle cell anemia patients, aged 1 to 19, we explore the hypothesis that gallstones (usually pigment stones) create a nidus of infection, predisposing the affected patients to high morbidity. Our study involved 86 children with sickle cell anemia at the Howard University Center for Sickle Cell Disease, who had been followed at the clinic for a total of 602 patient years. Review of their records revealed that patients with gallstones had a mean number of 10.24 hospitalizations and 25.35 ambulatory visits; those without gallstones had a mean number of only 4.26 hospitalizations and 13.41 ambulatory visits. In children with sickle cell anemia and gallstones, elective cholecystectomy (or, in the future, cholelithotripsy) could reduce the high morbidity caused by infection.