Autoimmune Liver Disease in Patients with Sickle Cell Disease

Orith Waisbourd-Zinman, Rachel Frenklak, Odelia Hakakian, Didja Hilmara, Henry Lin

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Hepatic and biliary tract diseases are common in sickle cell disease (SCD) patients, likely due to sickling, hemosiderosis, viral hepatitis, or cholelithiasis. Literature is lacking on associations between SCD, autoimmune hepatitis (AIH), and/or sclerosing cholangitis (SC)-together, autoimmune liver disease (AILD). We aimed to better understand the relationship of these diseases in pediatric patients. Materials and Methods: A retrospective analysis of patients with SCD and AILD at the Children's Hospital of Philadelphia (January 2008 to August 2015). Results: Seven patients, ages 8 to 23 years (3 males), were identified. Three had AIH, 2 SC, and 2 AIH/SC overlap, known as autoimmune SC. All patients with AIH treated with azathioprine significantly improved their liver enzymes. One patient with SC and inflammatory bowel disease underwent successful bone marrow transplant. Two SC patients died from SCD complications. Conclusions: In this cohort, there seems to be an association between SCD and AILD; SC in this population was severe. Physicians should be aware of this and evaluate patients with SCD and elevated liver enzymes for AILD.

Original languageEnglish (US)
Article number1985
JournalJournal of Pediatric Hematology/Oncology
DOIs
StateAccepted/In press - 2020

Keywords

  • autoimmune hepatitis
  • autoimmune liver disease
  • pediatric hematology
  • sclerosing cholangitis
  • sickle cell disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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