الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Thalassemia is among the most common genetic disorders, and nearly 7% of the world population carry a hemoglobinopathy. The burden of this disorder in many regions is of such a magnitude that it represents a major public health concern. Transfusion therapy which is the main way of treatment allows for normal growth and suppresses ineffective erythropoiesis. Iron overload is often inevitable, especially when iron chelating agents are not used properly . Even in the absence of transfusion, the accelerated rate of erythropoiesis enhances dietary iron absorption from the gut, resulting in a chronic state of iron overload. As patients with thalassemia commonly receive transfusions, they are exposed to transfusion-associated infections, where hepatitis B and hepatitis C are the most common infections detected. Iron overload and hepatitis-C virus (HCV) infection, have been implicated in the evolution of liver disease, in patients with transfusion-dependent beta-thalassaemia major (BTM). The impact of these factors in late stages of liver disease with BTM, has not been extensively studied yet. Interrelationship between iron overload, HCV infection and liver injury is still controversial. Multicenter cross-sectional studies have reported that the development and the severity of liver injury are strongly related to the extent of liver iron overload and to the presence of chronic HCV infection. Hepatitis virus C infection is the main risk factor for liver injury in transfusion-dependent thalassemics. on the other hand suggested that in the late stages of liver disease in BTM patients, iron overload may be the critical determinant, since fibrosis is related to the minimal haemosiderosis, independently of HCV history. Injury to the liver, whether acute or chronic, eventually results in an increase in serum concentrations of Alanine transaminase (ALT) and Aspartate transaminase (AST). We aimed in this study to detect the prevalence of liver disease in thalassemia major children in Children Hospital of Assiut University. The study included 100 patients with known thalassemia major their ages ranged from 1.1-17 years with Mean±SD 8.54±4.59 Median(IQ) 7(5 - 13), 56% with family history of the same disease We found that there is strong correlation between S.ferritin and liver function test (ALT, AST).and 12% of our patients was HCV ab positive and in these patients there is significant increase of liver function test and S.ferritin. In patients receiving chelation there is increase in ALT and significant decrease in S.ferritin