Sickle cell disease is an autosomal recessive disorder. The vas-occlusive crises lead to microinfarcts in the microvasculature in all organs, including the liver causing acute and chronic vascular complications in the form of ischemia, sequestration, and thrombosis, it also causes acute on top of chronic hepatic manifestations. Lifelong hemolytic anemia leads to precipitations of bile salts, bile pigments in intrahepatic, and extrahepatic bile ducts, which cause an important part of liver problems in sickle cell disease. Many other etiological factors could cause sickle cell disease hepatopathy. Liver problems in such patients could be fatal complications. Dealing with these complications based on the etiological factors provides a more accurate diagnosis for the overlapping liver manifestations in sickle cell disease, which means better treatment; it also simplif ies this complicated medical issue. Sickle cell disease patients require periodic biochemistry and imaging studies to detect and treat hepatic complications as soon as possible.
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