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Cholelithiasis in children and adolescents with sickle cell disease: Experience in a resource-limited setting
Oluwafunmilayo Funke Adeniyi1, Adeseye Micheal Akinsete1, Emuobor Aghoghor Odeghe2
1Department of Paediatrics, Paediatric Gastroenterology Unit, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Idi-Araba, Nigeria.
Insights
Cholelithiasis (gallstones) affects 13.6% of children with sickle cell disease (SCD) in Nigeria, particularly adolescents. Frequent crises are linked to gallstone development in pediatric SCD patients.
Area of Science:
- Pediatric Hematology
- Gastroenterology
- Medical Imaging
Background:
- Sickle cell disease (SCD) is common in Nigeria and can lead to gallstones (cholelithiasis), even in children.
- There is limited data on the occurrence of cholelithiasis in pediatric SCD patients in Nigeria.
- This study addresses the knowledge gap by investigating cholelithiasis prevalence in this population.
Purpose of the Study:
- To determine the prevalence of cholelithiasis in children and adolescents with SCD in Lagos, Nigeria.
- To identify socio-demographic and clinical factors associated with cholelithiasis in pediatric SCD.
- To document the relationship between hydroxyurea use and cholelithiasis.
Main Methods:
- A cross-sectional study was conducted involving 147 children and adolescents (aged 1-19 years) with SCD.
- Participants underwent sonographic examination of the gall bladder.
- Data on socio-demographics, clinical symptoms, laboratory parameters, and hydroxyurea use were collected and analyzed.
Main Results:
- The prevalence of cholelithiasis was 13.6%, higher in adolescents (21.4%) than younger children (6.5%).
- All identified cases of cholelithiasis were asymptomatic.
- Increased age and higher frequency of sickle cell crises were significantly associated with cholelithiasis.
Conclusions:
- The observed prevalence of cholelithiasis in pediatric SCD patients is notably high.
- Routine gallstone screening is recommended for older children and adolescents with SCD, especially those experiencing frequent crises.
- Further longitudinal research is advocated to explore the potential relationship between hydroxyurea and cholelithiasis.
Background:
Sickle cell disease (SCD) remains prevalent in Nigeria and can be complicated by cholelithiasis even in children. There is still a dearth of knowledge about the occurrence of cholelithiasis in these children. The present study is aimed to determine the prevalence of cholelithiasis in pediatric SCD in Lagos and documents relevant socio-demographic and clinical correlates.
Subjects And Methods:
This was a cross-sectional study of children and adolescents aged 1-19 years with SCD attending the Paediatric Haematology Clinic of the Lagos University Teaching Hospital. One hundred and forty-seven children were consecutively recruited into the study over 3 months and they all had sonographic examination of the gall bladder. The association between cholelithiasis, sociodemographic data, clinical symptoms, laboratory parameters, and the use of hydroxyurea was also documented.
Results:
The median age (range) of the study participants was 9.0 (1-19) years and majority were males (59.9%). The prevalence of cholelithiasis was 13.6% and the condition was most prevalent in adolescents (21.4%) compared to the younger children (6.5%). All the children with cholelithiasis were asymptomatic. Age and the frequency of crisis were significantly associated with cholelithiasis on multivariate analysis (P = 0.03, 0.045, respectively). The use of hydroxyurea was not significantly related to the occurrence of cholelithiasis.
Conclusion:
The prevalence of cholelithiasis observed in this study is high. Routine screening of older children and adolescents with SCD, especially with the frequent crisis is suggested. Longitudinal studies to establish the relationship between hydroxyurea and cholelithiasis is also advocated.
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