Features of gallstones in adult sickle cell patients

Morpho-constitutional analysis of gallstones revealed significant differences between sickle cell patients and other gallbladder stone formers. As expected, pigment stones, mainly composed of calcium bilirubinates, were the most common type of stones in the former (74.7 versus 22.5%, p < 10-6), which could be explained by haemolysis. However, if we consider that only 25% of sickle cell patients form stones in the bile ducts, this suggests that other factors could be involved such as mutations in the UGT1A1 gene. While calcium phosphates were found with the same frequency as the main component of gallstones in both groups, a high proportion of gallstones that had nucleated from carbapatite were observed in sickle cell patients in comparison to patients without sickle cell disease (23.5% versus 5.5%, p < 0.0001). In addition, among sickle cell patients, those who were homozygous were more prone than heterozygous subjects to form pigment gallstones from calcium phosphate (31.4 versus 5.9%, p < 0.01).