41 cases (31.16%) had autosplenectomy
while 32 cases (26.67%) had splenomegaly.
The important point here was whether or not spleen will go to autosplenectomy
. However, splenectomy was performed in most of the surgical procedures in the past.
Surgery was done in three (25%) patients only while four (33.3%) patients were treated conservatively, one patient who was also having thalassemia trait ended up in autosplenectomy
The platelet count in patients of SCD was significantly higher than control [P<0.05]--which may be due to loss of splenic platelet pool function in adult sickle cell patients consequent upon autosplenectomy
. This result is in agreement with previous studies.
(%) P Frequent VOC episodes (> 3/y) 28 (28.3) 62 Hyposplenism (autosplenectomy
) 25 (25.3) 17 Avascular necrosis of femur or humerus 23 (23.0) 90 Liver disease (with or without HCV infection) 6 (6.0) 43 Cardiovascular disease (pulmonary hypertension and cardiomyopathy) 2 (2.0) 99 Renal impairment 6 (6.0) 48 Gallbladder stones 22 (22.2) 51 Osteoporosis 1 (1.0) 86 Abbreviations: HCV, hepatitis C virus; VOC, vaso-occlusive crisis.
Hyposplenism (or asplenia or autosplenectomy
) is defined as under functioning of the spleen which may or not be associated with a reduction in splenic size.3
Therefore hydroxyurea treatment should be initiated in infancy to prevent chronic endothelial damage induced end-organ insufficiencies including autosplenectomy
to relieve permanent inflammatory process all over the body to decrease frequency of hospitalizations and eventually to restore immunity against infectious agents.14
(4) CT can also demonstrate splenic infarcts with focal calcifications or a small and dense calcified spleen (autosplenectomy
), which can aid the differential diagnosis.
Splenic size maybe as small as 0.5-1 cm in case of autosplenectomy
, and also can show decreased signal intensity on T1 and T2 weighted MR images related to iron deposition from chronic blood transfusions and/or calcifications [3,4].
(7) In later years, however, "autosplenectomy
" commonly occurs, the spleen becomes firm, smaller and nodular with depressed scars and finally reduced into a small wrinkled remnant often buried in adhesions.
The thrombocytosis could result from autosplenectomy
, as the spleen could pool between 20-40% of the total body platelets  that become available in the circulation when the spleen is nonfunctional.
Children with homozygous SCD (SS) achieve complete splenic dysfunction by age 5 years when the spleen is replaced by fibrotic tissue -- a process called autosplenectomy