{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T12:26:02Z","timestamp":1793881562633,"version":"4.7.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T00:00:00Z","timestamp":1689120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Sickle cell disease (SCD) is one of the most common monogenic disorders worldwide and liver complications are common in this group of patients. Our study aims to highlight the prevalence of chronic liver complications and the main predisposing factors for advanced liver fibrosis in SCD patients. For this purpose, 219 patients from eight Thalassemia and Sickle Cell Units across Greece enrolled in our study and history of liver related disease complications was recorded, as well as a full laboratory and imaging analysis concerning their liver function. 13.6% of the patients had advanced liver fibrosis. The presence of liver fibrosis was significantly correlated with advanced age, male gender, cholelithiasis and higher LDH, \u03b3\u2010GT, INR, direct and indirect bilirubin levels. These patients had exhibited significantly more episodes of liver crises and acute intrahepatic cholestasis. No correlation was observed with right heart failure or previous viral hepatitis. Patients with advanced liver fibrosis were receiving a more intensive transfusion therapy for a longer period of time and had higher Liver Iron Concentration levels. Our study shows that liver complications and cirrhosis is a significant cause of morbidity in patients with SCD and it is primarily associated with intravascular hemolysis and vaso\u2010occlusive phenomena and secondarily with iron overload.<\/jats:p>","DOI":"10.1111\/bjh.18970","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:19:47Z","timestamp":1689207587000},"page":"1192-1198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Predisposing factors for advanced liver fibrosis in patients with sickle cell disease"],"prefix":"10.1111","volume":"202","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9844-2813","authenticated-orcid":false,"given":"Konstantinos","family":"Manganas","sequence":"first","affiliation":[{"name":"Thalassemia and Sickle Cell Unit Hippokration General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Delicou","sequence":"additional","affiliation":[{"name":"Thalassemia and Sickle Cell Unit Hippokration General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Xydaki","sequence":"additional","affiliation":[{"name":"Thalassemia and Sickle Cell Unit Hippokration General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Kourakli","sequence":"additional","affiliation":[{"name":"Thalassemia &amp; Hemoglobinopathies Unit, Hematology Division, Department of Internal Medicine University of Patras Medical School, University Hospital  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loukia","family":"Evliati","sequence":"additional","affiliation":[{"name":"Thalassemia and Sickle Cell Unit General Hospital of Athens \"Evaggelismos\"  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efthymia","family":"Vlachaki","sequence":"additional","affiliation":[{"name":"Thalassemia and Sickle Cell Unit Hippokration General Hospital, Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Klironomos","sequence":"additional","affiliation":[{"name":"Thalassemia and Sickle Cell Unit \"Venizelion\" General Hospital  Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michail","family":"Diamantidis","sequence":"additional","affiliation":[{"name":"Thalassemia and Sickle Cell Unit General Hospital of Larissa  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Lafiatis","sequence":"additional","affiliation":[{"name":"Thalassemia and Sickle Cell Unit \"Vostanio\" General Hospital of Mytilene  Mytilene Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5178-0655","authenticated-orcid":false,"given":"Antonios","family":"Kattamis","sequence":"additional","affiliation":[{"name":"\u201cAgia Sophia\u201d Children Hospital, First Department of Pediatrics National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Koskinas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hippokration General Hospital National and Kapodistrian University of Athens Medical School  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-018-3493-4"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2018.12.002"},{"key":"e_1_2_11_4_1","volume-title":"StatPearls","author":"Samuel SS","year":"2023"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-12-542076"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2020.08.003"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i41.11567"},{"key":"e_1_2_11_8_1","unstructured":"AdeniyiO OdegheE AkinseteA OyelekeG MonkweyeiO Kene\u2010UdemezueB et al.Screenig for liver fibrosis in children and adolescents with sickle cell disease with the use of APRI and FIB4 score in a resource limited setting: a comparative study. 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