Clinical management of sickle cell liver disease in children and young adults

Arch Dis Child. 2021 Apr;106(4):315-320. doi: 10.1136/archdischild-2020-319778. Epub 2020 Nov 11.

Abstract

Liver involvement in sickle cell disease (SCD) is often referred to as sickle cell hepatopathy (SCH) and is a complication of SCD which may be associated with significant mortality. This review is based on a round-table workshop between paediatric and adult hepatologists and haematologists and review of the literature. The discussion was prompted by the lack of substantial data and guidance in managing these sometimes very challenging cases. This review provides a structured approach for the diagnosis and management of SCH in children and young adults. The term SCH describes any hepatobiliary dysfunction in the context of SCD. Diagnosis and management of biliary complications, acute hepatic crisis, acute hepatic sequestration and other manifestations of SCH are discussed, as well as the role of liver transplantation and haemopoietic stem cell transplantation in the management of SCH.

Keywords: adolescent health; gastroenterology; jaundice.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Anemia, Sickle Cell / complications*
  • Anemia, Sickle Cell / diagnosis
  • Anemia, Sickle Cell / epidemiology
  • Anemia, Sickle Cell / therapy*
  • Child
  • Digestive System Diseases / diagnosis
  • Digestive System Diseases / physiopathology
  • Digestive System Diseases / therapy*
  • Hematopoietic Stem Cell Transplantation / methods
  • Humans
  • Incidence
  • Interdisciplinary Communication
  • Iron Overload / diagnosis
  • Iron Overload / etiology
  • Iron Overload / therapy
  • Liver Diseases / etiology*
  • Liver Diseases / immunology
  • Liver Diseases / mortality
  • Liver Diseases / pathology
  • Liver Transplantation / methods
  • Monitoring, Physiologic / standards
  • United Kingdom / epidemiology
  • Young Adult