Profile of alanine aminotransferase and hepatic iron accumulation in thalassemic patients with or without anti-hepatitis C virus
Keywords:
alanine aminotransferase, hepatic iron accumulation, transferrin saturation, anti hepatitis C virus, thalassemia
Abstract
Background Repeated blood transfusions in thalassemic patientscause iron accumulation in tissues and might impair organ func-
tion. Other peril of blood transfusion is hepatitis C virus infection.
Objectives This study aimed to find out the proportion of increased
alanine aminotransferase (ALT), increased transferrin saturation
(TS), and positive anti hepatitis C virus (anti-HCV) among thalas-
semic patients and to get the profile of ALT among thalassemic
patients who have increased TS and positive anti-HCV.
Methods This cross-sectional descriptive study was conducted
on β- and β-HbE-thalassemic patients at the Thalassemia Outpa-
tient Clinic, Department of Child Health, Medical School, Univer-
sity of Indonesia–Cipto Mangunkusumo Hospital in May 2002.
Results Subjects were 57 homozygous β-thalassemic and 33 β-
HbE-thalassemic patients. No one had regular desferoxamine or
history of splenectomy. Proportions of increased ALT, TS, and posi-
tive anti-HCV were 76%, 78%, and 6%, respectively. Duration of
illness, total volume of packed red cell (PRC) transfusions, TS level,
and positive anti-HCV seemed to have role in the increased pro-
portion of subjects with increased ALT, whereas duration of illness
and total volume of PRC seemed to have role in the increased TS.
Conclusion Factors that seem to have a role in the increased
proportion of subjects who had increased ALT and TS were (1)
duration of illness, total volume of PRC transfusion, TS, and posi-
tive anti-HCV; 2) duration of illness and total volume of PRC trans-
fusion, respectively
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transfused hemogenous thalassemia patients. Hepatol
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semia and patients with liver diseases in Myanmar (Bur-
man) [abstract]. Acta Med Okayama 2000;54:137-8.
21. Roesli T. Hubungan peningkatan saturasi
transferin, infeksi virus hepatitis B dan C dengan
gangguan fungsi hati pada penderita thalassemia
beta mayor [thesis]. Jakarta: Department of Clini-
cal Pathology, Medical School, University of Indo-
nesia; 2001.
22. Wonke B, Hoffbrand AV, Braun D, Ducheiko G. Anti-
body to hepatitis C virus in multiply transfused patients
with thalassaemia major. J Clin Pathol 1990;43:638-40.
23. Lau YL. Hepatitis C virus antibody in multiply trans-
fused Chinese with thalassaemia major [abstract]. Bone
Marrow Transplant 1993;12 (Suppl 1):26-8.
24. Saberi-Firoozi M, Yazdankhah S, Karbasi HT. Anti-
HCV seropositivity among multiply transfused patients
with b-thalassaemia major in Southern Iran. Iran J Med
Sci 1996;21:59-60.
25. Al-Fawaz T, Remia S. Decline in hepatitis B infection
in sickle cell anaemia and b thalassaemia major. Arch
Dis Child 1993;69:594-6.
26. Vullo R, Modell B, Georganda E. Question about iron
overload and desferal. In: What is thalassaemia? 3 rd
ed. Nicosia: Thalassaemia International Federation;
1995. p. 26-8.
27. Li CK, Chik KW, Lam CWK, To KF, Yu SCH, Lee V.
Liver disease in transfusion dependent thalassaemia
major. Arch Dis Child 2002;86:344-7.
28. Bhatti FA, Amin M, Saleem M. Prevalence of anti-
body to hepatitis C virus in Pakistani thalassaemics by
practice agglutination test utility C 200 and C 22-3
viral antigen coated particles. J Pak Med Assoc
1995;45:269-71.
Wahidiyat I, Gatot D, Mangunatmadja I, editors.
Perkembangan mutakhir penyakit hematologi onkologi
anak. PKB IKA XXIV FKUI 1991. Jakarta: Bagian IKA
FKUI; 1991. p. 109-12.
2. Hematology subdivision. Petunjuk diagnosis dan
tatalaksana kasus thalassemia. Jakarta: Bagian IKA
FKUI/RSCM; 1997. p. 1-20.
3. Weatherall DJ, Clegg JB. The b thalassemias. In: The
thalassemia syndromes. 3 rd ed. Oxford: Blackwell Sci-
entific Publications; 1981. p. 148-631.
4. Wirawan R, Lembar S. Hemokromatosis: klasifikasi,
diagnosis dan penatalaksanaan. Maj Kedok Indon
2000;50:296-303.
5. Modell CB. Management of thalassaemia major. Br
Med Bull 1976;32:270-6.
6. Bacon BR, Brown KE. Iron metabolism and disorders of
iron overload. In: Kaplowitz N, editor. Biliary diseases.
2 nd ed. Baltimore: Williams & Wilkins; 1996. p. 349-62.
7. Bonkovsky HL, Ponka P, Bacon BR. An update on iron
metabolism: summary of the fifth international con-
ference on disorders of iron metabolism. Hepatology
1996;24:718-29.
8. Sharma BK, Bacon BR, Britton RS, Park CH, Magiera
CJ, O’Neill R, et al. Prevention on hepatocyte injury
and lipid peroxidation by iron chelators and a-tocopherol
in isolated iron-loaded rat hepatocytes. Hepatology
1990;12:31-9.
9. Zulkarnain Z. Tinjauan multi aspek hepatitis virus C
pada anak. In: Zulkarnain Z, Bisanto J, Pujiarto PS,
Oswari H, editors. Tinjauan komprehensif hepatitis vi-
rus pada anak. PKB IKA XLIII FKUI. Jakarta: Balai
Penerbit FKUI; 2000. p. 57-72.
10. Bonkovsky HL, Banner BF, Rothman AL. Iron and
chronic viral hepatitis. Hepatology 1997;25:759-68.
11. Bassett SE, Di Bisceglie AM, Bacon BR, Sharp RM,
Govindarajan S, Hubbard GB, et al. Effects of iron load-
ing on pathogenicity in hepatitis C virus-infected chim-
panzees. Hepatology 1999;29:1884-92.
12. Desforges JF. Screening for hemochromatosis. N Engl
J Med 1993;328:1616-20.
13. Powell LW, George K, McDonnell SM, Kowdley KV.
Diagnosis for hemochromatosis. Ann Intern Med
1998;129:925-31.
14. Pratt DS, Kaplan MM. Evaluation of abnormal liver-
enzyme results in asymptomatic patients. N Engl J Med
2000; 342:1266-71.
15. Gruen JR, Goei VL, Capossela A, Chu TW. Hemochro-
matosis in children. In: Suchy FJ, editor. Liver disease in
children. 1 st ed. St. Louis: Mosby; 1994. p. 773-80.
16. Kaplan MM. Laboratory tests. In: Schiff L, Schiff ER,
editors. Diseases of the liver. 7 th ed. Philadelphia: JB
Lippincott Company; 1993. p. 108-44.
17. Maller ES. Laboratory assessment of liver function and
injury in children. In: Suchy FJ, editor. Liver disease in
children. 1 st ed. St. Louis: Mosby; 1994. p. 269-93.
18. Kelly DA. Useful investigations in the assessment of liver
disease. In: Diseases of the liver and biliary system in
children. Oxford: Blackwell Science Ltd; 1999. p. 3-8.
19. Jaiswal SPB, Chitnis DS, Jain AK, Inamdar S, Porwal
A, Jain SC. Prevalence of hepatitis viruses among multi-
transfused hemogenous thalassemia patients. Hepatol
Research 2001;19:247-53.
20. Okada S, Taketa K, Ishikawa T, Koji T, Swe T, Win N, et
al. High prevalence of hepatitis C in patients with thalas-
semia and patients with liver diseases in Myanmar (Bur-
man) [abstract]. Acta Med Okayama 2000;54:137-8.
21. Roesli T. Hubungan peningkatan saturasi
transferin, infeksi virus hepatitis B dan C dengan
gangguan fungsi hati pada penderita thalassemia
beta mayor [thesis]. Jakarta: Department of Clini-
cal Pathology, Medical School, University of Indo-
nesia; 2001.
22. Wonke B, Hoffbrand AV, Braun D, Ducheiko G. Anti-
body to hepatitis C virus in multiply transfused patients
with thalassaemia major. J Clin Pathol 1990;43:638-40.
23. Lau YL. Hepatitis C virus antibody in multiply trans-
fused Chinese with thalassaemia major [abstract]. Bone
Marrow Transplant 1993;12 (Suppl 1):26-8.
24. Saberi-Firoozi M, Yazdankhah S, Karbasi HT. Anti-
HCV seropositivity among multiply transfused patients
with b-thalassaemia major in Southern Iran. Iran J Med
Sci 1996;21:59-60.
25. Al-Fawaz T, Remia S. Decline in hepatitis B infection
in sickle cell anaemia and b thalassaemia major. Arch
Dis Child 1993;69:594-6.
26. Vullo R, Modell B, Georganda E. Question about iron
overload and desferal. In: What is thalassaemia? 3 rd
ed. Nicosia: Thalassaemia International Federation;
1995. p. 26-8.
27. Li CK, Chik KW, Lam CWK, To KF, Yu SCH, Lee V.
Liver disease in transfusion dependent thalassaemia
major. Arch Dis Child 2002;86:344-7.
28. Bhatti FA, Amin M, Saleem M. Prevalence of anti-
body to hepatitis C virus in Pakistani thalassaemics by
practice agglutination test utility C 200 and C 22-3
viral antigen coated particles. J Pak Med Assoc
1995;45:269-71.
Published
2016-10-10
How to Cite
1.
P P, Kartoyo P, Chair I, Bisanto J, Oswari H. Profile of alanine aminotransferase and hepatic iron accumulation in thalassemic patients with or without anti-hepatitis C virus. PI [Internet]. 10Oct.2016 [cited 13Nov.2024];44(3):85-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/741
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Received 2016-09-29
Accepted 2016-09-29
Published 2016-10-10
Accepted 2016-09-29
Published 2016-10-10
