Splenectomized patients

Fig. 5. Spiculed red blood cells (echinocyte) in peripheral blood smear of a splenectomized patient with pyruvate kinase deficiency.

De Virgiliis S, Galanello R, Cao A. Plasmodium malariae transfusion malaria in splenectomized patients with thalassemia major. J Pediatr 1981 98(4) 584-5. 

Jakacki R, Luery N, McVerry P, Lange B. Haemophilus influenzae diphtheria protein conjugate immunization after therapy in splenectomized patients with Hodgkin disease, Ann Intern Med 1990 112(2) 143-4. 

HbH and many unstable hemoglobins spontaneously precipitate within the red cells, forming Heinz bodies, which can be detected in splenectomized patients by staining with methylene blue. Alternatively, precipitation of these hemoglobins can be induced and the precipitates visualized by incubation of the erythrocytes with a redox dye such as brilliant cresyl blue (Chapter 28). 

Hadem J, Cornberg M, Hauptmann C, Silttmann U, Manns MP, Wedemeyer H. Pneumococcal meningitis during antiviral treatment with interferon and ribavirin in a splenectomized patient with chronic hepatitis C—do not miss vaccination before starting therapy. Z Gastroenterol 2008 46(9) 880-2. 

Patients with mild cases of HS often do not need any treatment. However, these patients should be watched carefully for the development of hemolytic or aplastic crisis. Splenectomy is the treatment of choice in moderate-to-severe HS cases. In general, splenectomy is indicated in patients who are continuously anemic or who have a history of gallstone colic or repeated crises. The clinical results of splenectomy for HS are almost uniformly excellent. However, splenectomy in very young children should be postponed to later in childhood because splenectomized infants are more susceptible to serious and potentially lethal infections than are older children and adults. At the time of splenectomy, it is important to identify and remove any accessory spleen otherwise, the operation will... 

Fig. 20. The formation of Heinz bodies in a subject with the unstable hemoglobin Louisville. The patient was splenectomized at the age of 21 years. From Keeling et al. (K9) with permission of the authors and publisher. 

Transfusion-induced malaria may be a life-threatening complication, especially in patients who have been repeatedly transfused, treated with immunosuppressive drugs, or splenectomized (190). The disease is readily transmitted from asymptomatic donors with latent infection. Means of preventing and treating transfusion-transmitted malaria are well defined in current literature (191,192). To prevent malaria transmission, donors from malaria-endemic areas are now only accepted after spending 3 years in a malaria-free area this interval may well be too short. 

In 1958 SvENNERHOLM determined the normal serum cerebroside level with newer methods and found a value of 4.36 0.18 mg per 100 ml. The average serum cerebroside level in 6 splenectomized Gaucher patients was twice normal, namely... 

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