Association of vaso-occlusive crisis frequency with hepatic fibrosis in patients with sickle cell disease: a hospital-based observational study

Abstract

Background: Sickle cell disease (SCD) is characterized by recurrent vaso-occlusive crises (VOC) and progressive multi-organ damage, including hepatic fibrosis. While iron overload is a known contributor to liver injury, the role of crisis frequency in hepatic fibrosis remains underexplored. This study aimed to evaluate the association between vaso-occlusive crisis frequency and hepatic fibrosis in patients with sickle cell disease.

Methods: This hospital-based cross-sectional observational study included 50 patients with confirmed sickle cell disease attending a tertiary care hospital in Dibrugarh, Assam. Liver stiffness measurement (LSM) was assessed using shear wave elastography as a surrogate marker of hepatic fibrosis. Crisis frequency, transfusion history, and iron profile parameters were recorded. The association between crisis frequency and liver stiffness was analysed using one-way analysis of variance (ANOVA).

Results: The mean LSM was 6.62±1.35 kPa. Fibrosis staging revealed 22% of patients in F0-F1, 62% in F2, and 16% in F3. Patients with higher crisis frequency had significantly increased liver stiffness compared to those with fewer crises (p=0.004). A statistically significant positive association was observed between crisis frequency and hepatic fibrosis.

Conclusions: Increased vaso-occlusive crisis frequency is associated with higher liver stiffness and may serve as a clinical predictor of hepatic fibrosis in SCD. Early identification of high-risk patients may facilitate timely monitoring and intervention.