Assessing the value of fibro scan in the detection of liver fibrosis among patients with sickle cell disease- a single center study.

BACKGROUND

Sickle cell hepatopathy (SCH) is a general term used to describe the acute and chronic manifestations of liver damage in sickle cell disease (SCD). One of the most effective methods used to examine the liver is transient elastography (Fibro Scan), a noninvasive, rapid, and reproducible method that can assess liver fibrosis by measuring liver stiffness.

Objectives

This single-center study aims to investigate the role of transient elastography (Fibro Scan) in the detection of liver disease among patients with SCD in the Eastern Province of Saudi Arabia, where the rates of SCD are found to be among the highest.

Design

This is a prospective, observational study.

METHODS

The study was conducted among n=101 SCD patients of any phenotype between January and December 2024. Data on demographics, hospitalization rates, hydroxyurea use, transfusion, and complications were obtained from the health informatics system. All included patients were examined using non-invasive transient elastography (Fibro Scan) for the presence of fibrotic changes.

RESULTS

Among n = 101 SCD patients, 13.9% had G6PD deficiency, 40.6% required one hospitalization per year, and 65.3% required blood transfusion. The transient elastography through Fibro Scan assessments revealed that 94.1% of patients had normal liver tissue (fibrosis score 2-7 kPa), 4.0% showed moderate scarring (7-11 kPa), and 2.0% had moderate to severe scarring (11-15 kPa). Radiographic evidence of fatty liver was present in 24.8% of cases, with a significant association with moderate or severe fibrosis (p = 0.049).

CONCLUSIONS

Patients with SCD without iron overload had a low prevalence of liver fibrosis. However, fatty liver in SCD likely leads to a risk of fibrosis progression, which is an area for further study.