Deranged liver enzyme status in thalassemic paediatric patients- is it hepatitis or iron overload?

  • Sheetal Arora Dept. of Patholog,ESIC Medical College, Faridabad, Haryana(India)
  • Deepshikha Rana Dept. of Patholog,ESIC Medical College, Faridabad, Haryana(India)
  • J.S Dhupia Dept. of Patholog,ESIC Medical College, Faridabad, Haryana(India)
  • Charanjeet Ahluwalia Dept. of Patholog,ESIC Medical College, Faridabad, Haryana(India)
Keywords: Hepatitis, ferritin, SGOT, SGPT


INTRODUCTION:The susceptibility to infections in thalassemia arises from a large spectrum of immunological abnormalities and from the exposure to infectious agents by allogenic blood transfusions. Increased hepatic iron may potentiate progression towards liver fibrosis in chronic HCV infection and may contribute to poor response to therapyOBJECTIVE: (1)To determine the prevalence of hepatitis B and hepatitis C in thalassemic paediatric patients. (2) To determine the relationship between elevated liver enzymes with serum ferritin and viral hepatitis in thalassemia.METHOD: Sera was obtained from 100 thalassemia children and was processed for anti-HCV and HBsAg, serum ferritin,ALT/SGPT & AST/SGOTRESULTS:100 subjects were evaluated. Eight subjects (8%) were HBsAg positive and six (75%)received more than 100 blood transfusions.Out of these eight subjects with, seven had raised SGOT, & six had raised SGPT. Four subjects were positive for hepatitis C & all of them (100%) received more than hundred blood transfusions.All four HCV subjects had raised SGOT & SGPT (p=0.037).SGOT was raised in 68% subjects and 47 (69%) had more than 100 blood transfusions (p=0.002). SGPT was raised in 49% subjects and 37 (75.5%) had more than 100 blood transfusions. 86% subjects had serum ferritin in range of 1000-2000ng/ml & 14% had serum ferritin <1000 ng/ml.Serum ferritin showed strong correlation with SGOT & SGPT (p=0.036 & p=0.002).CONCLUSIONS:Prevalence of hepatitis B in Thalassemic’s in our study was 8% while hepatitis B in general population is 4.35%. Hepatitis C was 4% in our study while that in children in general population is 0.31%. Serum ferritin showed significant correlation with SGOT & SGPT. This finding suggests that iron overload is one of the major causes of abnormal liver function in subjects with thalassemia.So the treatment of hepatitis as well as iron overload should be done to prevent progression to liver disease. DOI:10.21276/APALM.1616

Author Biographies

Sheetal Arora, Dept. of Patholog,ESIC Medical College, Faridabad, Haryana(India)
Assistant ProfessorDeprtment of Pathology
Deepshikha Rana, Dept. of Patholog,ESIC Medical College, Faridabad, Haryana(India)


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Original Article