Gallstones in Ghanaian children with sickle cell disease

Abstract

OBJECTIVE: This prospective, cross-sectional study was done to define the prevalence and age of onset of gallstones in Ghanaina children with Sickle Cell Disease (SCD) in steady state, using ultrasonography.MATERIALS AND METHOD:The study was conducted at the Paediatric SCD clinic, Korle Bu Teaching Hospital, Accra, Ghana. Three hundred and fifteen (315) children comprising 162 males and 153 females aged 2 to 13 years with a confirmed diagnosis of SCD of haemoglobin SS, (HbSS), Haemoglobin SC, (HbSC) or Haemoglobin S-betathalassemia (SbetaThal) genotype whose parents/guardians gave informed conset, were recruited consecutively. The main outcome measure was the detection of gallstones in the gall bladder or common bile duct by ultrasonography. RESULTS:Thirteen children, 12 males and 1 female had gallstone, giving an overall prevalence of 4%. The youngest was aged 6. Four children had sludge only. Peak age of prevalence was 12 years. All patients under 12 years with gallstone were males (92.3%). The very high male: female ratio in these sickle cell disease children is at variance with the normal male: female ratio of 1:4.6. Although twenty percent of all the patients were genotype SC, only one SC patient had gallstones, giving a prevalence rate of 0.3%, and a prevalence ratio of stone in SS: SC of 12:1. Twenty patients had no spleen detectable clinically or on ultrasoound examination and none of them had gallstones. CONCLUSION:Gallstones occur at an early age in children with sickle cell disease in Ghana.