Hepatopulmonary

syndrome associated with iron overload in sickle cell anaemia To the Editors: At present, it is estimated that 10,000 to 20,000 patients in the USA are treated with long-term blood transfusion [1], includ-ing patients with sickle cell disease (SCD) who are often transfused to prevent stroke [2, 3]. Iron overload is common in patients with recurrent transfusion, and the degree of iron overload may correlate with the rate of transfusions [4, 5]. While iron overload and cirrhosis have not been definitively linked in patients with SCD,.11 % of patients with SCD were found to have cirrhosis on autopsy and a possible link has long been suggested [6]. Hepatopulmonary syndrome (HPS) is a common pulmonary complication of cirrhosis, occurring in 5–32 % of patients wit