Liver dysfunction following splenectomy in idiopathic myelofibrosis: a study of 10 patients.
The hepatic abnormalities that developed after the splenectomy in 10 subjects with idiopathic myelofibrosis were analyzed. In all patients in whom a liver biopsy was performed during the splenectomy, extramedullary hematopoiesis was demonstrated, consisting of dysmorphic megakaryocytes primarily localized in the sinusoids, often accompanied by erythroid precursors. Following splenectomy, a significant increase in both the liver size and serum levels of alkaline phosphatase, bilirubin or gamma-glutamyl transpeptidase was found within 6 months, whereas no such increase was observed in the serum aspartate transaminase and alanine transaminase concentrations. In addition, 2 patients developed acute liver failure leading to death at 3 and 4 weeks from splenectomy, respectively. In contrast with these findings, no hepatic alterations were observed in 10 chronic myeloid leukemia patients who were also submitted to splenectomy.
López-Guillermo
A
A
Postgraduate School of Hematology Farreras Valentí, University of Barcelona, Spain.
Cervantes
F
F
Bruguera
M
M
Pereira
A
A
Feliu
E
E
Rozman
C
C
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D005260:Female; D006411:Hematopoiesis, Extramedullary; D006412:Hematopoietic Stem Cells / Q000473:pathology; D006801:Humans; D007728:Kupffer Cells / Q000473:pathology; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology; D008297:Male; D008533:Megakaryocytes / Q000473:pathology; D008875:Middle Aged; D055728:Primary Myelofibrosis / Q000601:surgery*; D013156:Splenectomy / Q000009:adverse effects*; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D001663:Bilirubin