Sequential study ofliver biopsy inthalassaemia

SUMMARY Liver biopsies were performed in 47 thalassaemic children. 33 ofthem hadlaboratoryfindings that suggested chronic hepatitis; the other 14patients, withoutsuchsigns, underwentliverbiopsies during splenectomy. Ninepatients showed a moreor less pronouncedfibrosis, 26showedchronicpersistenthepatitis, and12hadhistologicalevidenceofchronicaggressivehepatitis. Thelast12patientswhohadbeentreatedwithcorticosteroids, and9 otherpatientswhoshowed a worseningof their liver function tests, underwent sequential biopsy. We suggest that chronic liver diseasein thalassaemicchildren can produceinflammatoryinfiltration even withoutbiochemical or clinicalsignofchronichepatitis,thatit canprogress towardscirrhosis even inpatientswithchronicpersistenthepatitis, andthatthere appears to be no benefitingivingcorticosteroids. Wehave previously reported our experience withthalassaemicliverdiseaseand we pointed out that, inaddition to iron overload, the basic liver lesion was caused by the presence ofchronic hepatitis.' Later