Scintigraphic diagnosis and computed tomographic localization of an accessory spleen following relapse of chronic immune thrombocytopaenia.
Chronic immune thrombocytopaenia is an immunologically mediated disorder resulting in disordered platelet kinetics and potentially life-threatening thrombocytopaenia. Failure of medical therapy is an indication for splenectomy, and responses are seen in 80% of patients following this procedure. An important cause of relapse following splenectomy is the presence of an accessory spleen. We describe a patient with Hodgkin's Disease who developed chronic immune thrombocytopaenia despite previous splenectomy. A remission was induced with immunosuppressive therapy, but he later relapsed. An accessory spleen was detected using 99mTc denatured red blood cells and localized using computed tomography (CT). Resection of the accessory spleen resulted in clinical remission. Accessory spleens are often small in size. Combined modality imaging is recommended in the evaluation of patients with a possible accessory spleen.
Cardaci
G T
GT
Nuclear Medicine Department, Royal Perth Hospital, Western Australia.
Blake
M P
MP
D001323:Autoantibodies / Q000032:analysis; D001792:Blood Platelets / Q000276:immunology; D002908:Chronic Disease; D006689:Hodgkin Disease / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012008:Recurrence; D013154:Spleen / Q000002:abnormalities* / Q000000981:diagnostic imaging; D013156:Splenectomy; D013667:Technetium; D013921:Thrombocytopenia / Q000276:immunology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
D001323:Autoantibodies; D013667:Technetium