Clinical pathology aspect on diagnosis cholelithiasis in β-Thalassemia patient: A case report

BACKGROUND: Thalassemia is categorized based on the abnormal globin chain and is divided into primary, intermediate, and minor subtypes based on the chain abnormality, respectively. CASE PRESENTATION: An Indonesian adolescent, 18 years old, complained of abdominal pain for 1-day. Medical history patient showed thalassemia for 13 years, routine control and received transfusions. Physical examination: Anemic conjunctiva (+/+), epigastric tenderness (+). Laboratory tests: Hb of 4.2 g/dL, MCV of 59.8 fL, and MCH of 19.6 pg. Peripheral blood smears showed microcytic hypochromic, target cells, and teardrop cells. Increased albumin: creatinine ratio ≥300 mg/gr. Hb Electrophoresis showed increased HbF and HbA2 fractions. Abdominal Ultrasound showed cholelithiasis. The patient performed laparoscopic cholecystectomy and was successful. DISCUSSION: Cholelithiasis is often found in thalassemia intermedia complications. Regular ultrasound examination in β-Thalassemia is used to detect cholelithiasis. CONCLUSION: Clinical pathology analysis supports the diagnosis of cholelithiasis in the β-Thalassemia patient.