Sickle cell hepatopathy results from the deposition of sickled RBCs in the sinusoids of the liver. This leads to sinusoidal dilation and occasionally hemorrhage into the parenchyma. This obstructive disease may lead to abnormal liver function tests. It is not a common cause of end-stage liver disease.
Sickle cell disease is also known to cause hepatopathy in the form of secondary iron overload, as these patients often require frequent blood transfusions. In addition, the chronic, intravascular hemolytic process characteristic of SSA promotes the formation of gallstones. Therefore, choledocholithiasis may also be responsible for symptomatic liver disease and abnormal LFT.]
In the histology above, note the dilated sinusoids (white spaces) filled with sickled RBC. Sometimes, extramedullary hematopoiesis occurs in SSA and megakaryocytes and other immature cells can be seen on histology.