Noninvasive assessment and risk factors of liver fibrosis in pediatric patients with beta thalassemia major using transient elastography

Abstract

Background In beta-thalassemia major (TM) patients, levels of liver iron overload and the presence of chronic hepatitis C are directly correlated with the onset and severity of liver fibrosis. A noninvasive approach that can evaluate cirrhosis and liver fibrosis in these patients is transient elastography (TE). We aimed to find out the role of noninvasive elastography in the assessment of liver fibrosis in young beta-thalassemia major patients receiving frequent blood transfusions. Identifying the patients' risk factors for liver fibrosis is another goal. The study comprised 53 patients, all of whom had a thorough history-taking procedure, clinical examination, and investigations such as CBC, serum ferritin, HCV and HBV serology, and liver function testing. It was carried out transient elastography to find liver fibrosis. Results According to transient elastography, 52.8% of the patients had severe fibrosis (F2 and higher). 9.4% of people had positive HCV serology results. Significant liver fibrosis was correlated with all serum ferritin levels (708.2 ± 182.1, 3213.5 ± 1272.9, nonsignificant vs. significant fibrosis), HCV infection, age, blood transfusion frequency, and irregular chelation therapy. But no significant correlation regarding sex and BMI was detected. Conclusion Transient elastography is an alternate noninvasive approach that assesses liver fibrosis in beta-thalassemia major patients. The risk of liver fibrosis is related to iron overload, HCV seropositivity, advanced age, frequent blood transfusion, and irregular chelation therapy.

Correlation Between Serum Ferritin and Degree of Hepatic Fibrosis on Fibroscan in Thalassemic Patients

“…The median value of SGPT was 38 IU/L, with a minimum value of 9 IU/L and a maximum value of 314 IU/L, which is higher than the values reported by Ferraioli et al [16] at 27 IU/L. The mean creatinine levels for our study were found to be 0.8 mg/dl, which is comparable to the results of previous research [11].…”

“…Consistent with previous research, our findings demonstrated a statistically significant positive correlation (r= 0.287; p= 0.033) between serum ferritin levels and hepatic fibrosis. In a study by Mohamed et al [ 11 ], serum ferritin levels were substantially correlated with hepatic fibrosis in thalassemia major patients. Several other studies [ 12 - 17 ] have also reported a significant positive correlation between serum ferritin levels and hepatic fibrosis.…”