Liver pathology in non-transfused thalassemia patients

Iron overload, hepatic fibrosis and cirrhosis are well recognized findings in thalassemic patients with multiple blood transfusions. Since most studies have been performed in patients receiving multiple transfusions, we selected 15 children with thalassemia major and intermediate, who had never been transfused. Our studies in 6 female and 9 males, aged 2 - 11 years, showed hepatic extramedullary haematopoiesis, but no fibrosis or cirrhosis. Iron pigments were also present from grade +1 to + 3 and correlated well with increasing age. Furthermore liver function tests were normal. It thus appears that hepatic fibrosis and cirrhosis are long term post-transfusions complications while iron overload may be present even in non-transfused patients